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Use of Psychotropic Medications for Patients With Office Visits Who Receive a Diagnosis of Panic Disorder

Objective:We sought to examine trends in the medication management of panic disorder from a nationally representative sample of visits to psychiatrists and primary care physicians in office-based practice. Method:We analyzed physician-reported data from the 1992–1995 and 1996–1999 National Ambulatory Medical Care Survey, focusing on medication management of panic disorder by primary care physicians and psychiatrists. Rates for which doctors prescribed medication for patients with a diagnosis of panic disorder were compared over the course of time to identify changes in medication management between physician groups. We used logistic regression models to identify predictors of medication prescription, adjusting for the presence of other covariates. Results:Both physician groups prescribed a psychotropic medication to a majority of patients for panic disorder in each time period. In 1992–1995, primary care physicians were less likely than psychiatrists to prescribe psychotropic medications. This difference was not evident in 1996–1999. The prescribing of benzodiazepines was common in both physician groups and time periods. Overall rates of psychotropic prescriptions by physician groups converged over time, although no single drug class accounted individually for the convergence. Conclusion:In recent years, changes in the medication management of patients with panic disorder by primary care physicians have resulted in greater similarity with the pharmacologic treatment of panic disorder provided in psychiatric practice.