Panic disorder. Pathophysiology and drug treatment

Area of Science:

• Neuroscience
• Psychiatry
• Pharmacology

Background:

• Panic disorder research has advanced significantly over the last two decades.
• This progress parallels the development of novel pharmacological agents targeting antipanic effects.
• Biological understanding aids in developing pharmaco-therapeutic strategies for panic disorder.

Purpose of the Study:

• To review the current understanding of panic disorder biology.
• To discuss the role of neurotransmitters in the etiology of panic disorder.
• To evaluate the effectiveness of different pharmacotherapeutic agents in treating panic disorder.

Main Methods:

• Review of current scientific literature on panic disorder biology and pharmacology.
• Analysis of evidence regarding neurotransmitter systems implicated in panic disorder.
• Evaluation of pharmacotherapeutic strategies based on biological understanding.

Main Results:

• Panic disorder is not linked to a primary disorder in a single neurotransmitter system.
• Abnormalities in serotonin (5-hydroxytyrptamine; 5-HT), noradrenaline, gamma-aminobutyric acid (GABA), dopamine, and cholecystokinin are implicated.
• Panic disorder may be biologically heterogeneous, with potential subtypes.
• Pharmacotherapeutic agents acting on GABA and serotonin systems show the most efficacy.

Conclusions:

• Current biological understanding informs panic disorder treatment strategies.
• While GABA and serotonin systems are key, other neurotransmitter systems and combinations may be relevant for some patients.
• Continued evolution of biological understanding will drive future pharmacotherapeutic advancements for panic disorder.