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Clinical Crossroads Update
July 24/31, 2002

A 28-Year-Old Woman With Panic Disorder, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2002;288(4):494. doi:10.1001/jama.288.4.494

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.

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