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The pharmacological treatment of pathological panic panic disorder

Publié par happy-diet mardi 6 avril 2010

The pharmacological treatment of pathological panic panic disorder is well proven, and for several decades, this was the situation dealt with, either an anti-anxiety factor of the category of "Bnzodiazibin" benzodiazepine a drug is an antidepressant, or treatment of a compound.

The other option is cognitive behavioral therapy cognitive behavioral therapy, which is the most effective psychological treatment for cases of panic.

It does not medicine or psychotherapy, and use both of them separately, are not effective for everyone.

Nearly 50 to 70 per cent of those infected were usually responsive to medication or to psychotherapy during the first few months of treatment.

And about 25 to 50 per cent of people who stop taking the medications, perhaps because of fears of sedatives or other symptoms, suffer from the return of the situation within six months.

This may be due partly to stop taking the medications (especially drugs "Bnzodiazibin"), can lead to the emergence of withdrawal syndrome or logoff uncomfortable.

As a result of this data, the hospitals, doctors advised patients need to gather psychotherapy along with medication.

However, the guidance the American Psychiatric Association that were updated in 2006, does not favor particular the trend towards collection of treatments, because the research did not show consistently that the collection of treatments provides benefits in respect of recovery.

However, the new analysis has provided additional support for the combination therapies to cases of panic.

The review concluded in 2007 conducted by the Foundation, "an international commission Cochran Kolaborishn" that the evidence was sufficient to make a recommendation to the effect that the first option, which provides to people with panic, you must be either a combination therapy, or psychotherapy alone - rather than drug therapy alone.

Challenges of treatment
One of the challenges during the treatment of panic, is that the situation is reflected images of many different symptoms.

Situation is characterized by the same scenes, recurrence, for fear or panic, a sudden, you can not control it.

These scenes, sacrifice scary when you see the symptoms of heart problems and blood vessels cut, such as breath, heart palpitations, or chest pain, nausea, or any of the forms of intestinal pain, and neurological problems such as fainting and a chill.

And around 2 to 5 per cent of people exposed to such attacks, will appear to have a panic, almost half of them before adulthood, and the other half later.

As that between a third and half of people with panic about who examined their cases in the studies of population groups, as well as suffering from "Agoraphobia" agoraphobia (ie away from public areas where it is difficult or awkward to be easy to find the port of exit).

This meeting between the two cases appear more among the people who are going to get medical assistance cases of panic.

And because the panic chronic, it should not doctors and patients, establish the means for the treatment to both acute only - panic attacks, the actual and the first few months later - but also to develop strategies to reduce or prevent panic attacks the next and ease concern that appears when you expect these episodes.

Medication tips
Tips on the side of drug of the combination therapy, has not changed much, it was concluded instruction manual Psychiatric Association American updated in 2006, that the Surge revisit the serotonin selective selective serotonin reuptake inhibitors (SSRIs), anti-"Trajsichaelk" the old blues tricyclic antidepressants, and medicines, "Bnzodiazibin" , were all equally effective in eliminating the symptoms of panic.

The intervention of several factors here, when it takes the doctors and patients to work together to make a decision by choosing the type of medicine, Val "Bnzodiazibin" would work quickly, within hours or days.

These drugs are often prescribed with antidepressants as a treatment first, and for ensuring the rapid disappearance of symptoms.

However, the benefits of eating two types of medicines rather than antidepressant alone, disappear within weeks, and therefore, the effect of the "Bnzodiazibin" is decreasing rapidly.

All the benefits of the fruit of love Bdoaiin treatment be weighed against the expected significant side effects.

Many antidepressants are effective for panic, but the drugs SSRI that is still described as the most, and that, on a large scale, because the Side effects are better accepted than drugs "Trasichaelk" old, which may cause dry mouth, constipation, and weight gain.

As new drugs anti-depressant of the double effect, which performs its task on two types of correspondence nerve, the "serotonin" serotonin and "Norippinivrin" norepinephrine, may be effective, although the data of clinical studies on the incidence of panic is only available for the drug "Vinlavaksin" venlafaxine ( Ivixwor) Effexor.

And the cost of the event and medicine disturbing, it is perhaps the best anti-reflection "Trasichaelk" for depression, drugs or SSRI.

Medical treatment and behavioral
Auditors recommended that, "Cochran" against the use of antidepressant medications alone, after analysis of 21 clinical trials involving 1709 patients.

The studies included adults sick people with panic, and the researchers assessed the efficiency of treatment in three time periods: during the early stages of treatment, during the final sustainability, and after treatment.

Became apparent that a more complex premises therapeutic effectiveness, the anti-depressant medication and cognitive behavioral therapy.

The form of this Alalajan both societies together ahead of a complex treatment compared to treatment with any of them for the same option, for both periods are short and the stage to be perpetuated.

However, it is and the extent to longer time, it was psychotherapy alone is effective as effective as combination therapy.

In Phase urgent or "acute" period, which usually goes on for two months or four months, the goal is to help people recover from a severe bout panic, and control of any of the other symptoms of preventing the occurrence of panic attacks again.

Although the studies known to respond to treatment in different ways, the researchers, "Cochran" divided the results to determine whether medical interventions have helped with access to a significant improvement in symptoms.

On the whole, studies have pointed to the acute phase of panic attacks, collecting two treatments of medical and psychological often led to the 24 per cent of cases, a significant improvement in symptoms, compared handling antidepressants alone, and about 17 per cent compared to psychiatric alone.

At one stage, the sustainability goal of treatment is to help the patient to avert a new panic attacks, as well as his return to the regular exercise of its functions.

During this phase, researchers also have concluded that the combination therapy appears superior to every one of the users on the two treatments separately.

Because a lot of people stop treatment with time, the Cochrane researchers also studied what happened after 6 to 24 months from the cessation of patients taking antidepressants or undergoing psychiatric treatment.

Here, the combination therapy was continued in being more effective than antidepressants alone, but he was no better than psychotherapy alone.

As long as the therapy has already reached a single treatment, to long-term results, the researchers recommend combination therapy or psychotherapy as the first choice for the injured.

Exposure therapy
The study concluded a separate review again that there is not enough evidence to recommend treatment of a compound of Medicine "Bnzodiazibin" and psychological treatment of cases of panic.

The researchers were able to identify two clinical trials contiguity of high scientific quality, have provided the answers.

These two studies were compared between treatment exposure and the exposure therapy "Bnzodiazibin" together, compared with exposure therapy alone in people with cases of panic and fear of the toilet.

Exposure and treatment of behavioral therapy is going to gradually increase exposure to the conditions that led to a panic attacks in the past.

The researchers said the results of these studies, together with the data that have not been published, which Radjaoha, have been limited, but it is assumed that the treatment runs down, it can be effective for people with panic and fear of the toilet, while not recommended for dealing drugs, "Bnzodiazibin" alone.

The addition of treatment with "Bnzodiazibin" Exposure to treatment may be superior to treatment runs down alone, during the early stages of treatment, although the benefits do not persist in the post.

Questions without answers
Although more people with panic being treated by primary care physicians in the clinics, the majority of studies on combination therapy may have occurred within hospitals.

Because primary care physicians may not know how to control their patients to cognitive behavioral therapy, it is unclear whether patients can benefit from it actually.

The doctors hospitals still need guidance on treatment options put drugs or psychotherapy together or sequentially, and about the possible transfer of patient from one species to another type of treatment, that does not work with the first treatment.

There is also evidence on the effectiveness of a number of psychological therapies is cognitive behavioral therapy to reduce symptoms of panic, such as relaxation training, stress control, and Hypnosis.

However, the analysis assumes that the overlay of modern drug therapy with cognitive behavioral therapy - or psychiatric treatment alone - most likely provide comfort for people with panic situations, more than drug therapy alone.

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