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Panic disorder: a clinical perspective on acute treatment and future research needs.

Panic disorder is a common disorder for which there are highly effective treatments. Patients usually present for treatment in acute distress and initially have difficulty responding to cognitive behavioral therapies. In contrast there is a high response rate to pharmacologic treatments. Cognitive behavioral techniques can be helpful in facilitating the taper and eventual discontinuation of medication and may play a role in preventing relapse. The disorder appears to have a chronic course requiring maintenance medication for at least six months. Phobic avoidance appears to be primarily a learned response and is best treated with in vivo desensitization.