Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Effective non-pharmacological interventions for managing panic disorder in a primary care setting include:
- Cognitive Behavioural Therapy (CBT): CBT is the recommended psychological treatment and should be delivered by suitably trained and supervised practitioners following empirically grounded protocols. Optimal CBT duration is 7 to 14 hours, typically delivered as weekly 1 to 2-hour sessions over a maximum of 4 months. Briefer CBT integrated with structured self-help materials is also effective for some patients NICE CG113.
- Low-intensity psychological interventions: For mild to moderate panic disorder, offer or refer for individual non-facilitated self-help or individual facilitated self-help based on CBT principles. These interventions involve written or electronic materials and minimal therapist contact, such as occasional short telephone calls or brief face-to-face sessions NICE CG113.
- Provision of written information and support: Patients should be given appropriate written information about panic attacks and sources of support, including local and national voluntary and self-help groups, which may provide face-to-face or telephone support based on CBT principles NICE CG113.
- Exercise: Discuss the benefits of exercise as part of good general health with all patients, as exercise has been shown to improve anxiety symptoms NICE CG113.
These interventions should be offered promptly in primary care, with shared decision-making guiding the choice of treatment. Referral to specialist mental health services is recommended if two interventions (psychological, medication, or bibliotherapy) have been tried without sufficient improvement NICE CG113.