At Psychiatry Grand Rounds held in January 2001, Jack Gorman, MD, discussed
the epidemiology, natural history, diagnosis, and treatment of panic disorder.1 The patient, Ms M, a 28-year-old woman, exhibited
palpitations and chest discomfort requiring multiple emergency department
visits. An extensive evaluation was undertaken to determine the origin of
her symptoms, but no medical cause was found. Her primary care physician,
Dr G, prescribed lorazepam for Ms M and referred her to a social worker. Gradually,
with the help of the social worker, Ms M was able to accept that her symptoms
were due to panic disorder. Her symptoms improved when she took lorazepam
as needed; however, the medication was switched to clonazepam because of formulary
changes. By the time of the conference, Ms M was able to control her symptoms
with relaxation techniques, and she needed to take clonazepam (0.5 mg) only
occasionally.