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Panic disorder
Other Resources UpToDate PubMed

Panic disorder

Contributors: Casey Silver MD, Abhijeet Waghray MD
Other Resources UpToDate PubMed


Panic disorder is characterized by spontaneous panic attacks, which are periods of intense fear that typically peak within 10 minutes and last 20-30 minutes. Attacks have no discernable trigger. Symptoms develop abruptly and include palpitations, sweating, trembling, sense of shortness of breath or choking, chest pain, nausea, dizziness, and lightheadedness. Patients often describe feelings of detachment, loss of control, impending doom, and/or a fear of dying. Mental status examination is typically normal. Patients often present in the emergency room with cardiac or pulmonary concerns from somatic symptoms.

Episodes are recurrent, and fear of attacks leads to significant behavioral changes, such as avoidance of specific situations or locations and/or personality changes. Other symptoms experienced in between attacks include headache, diarrhea, insomnia, fatigue, and ruminations.

Panic disorder is a common psychiatric disorder that demonstrates significant heredity. Women are more likely to be affected than men. The average age of onset is 24 years, with most patients developing the condition between the ages of 18 and 45 years. Over 80% of patients have another psychiatric disorder, most often a mood disorder, such as depression, or substance use disorder. Common comorbid medical conditions include chronic obstructive pulmonary disease (COPD), irritable bowel syndrome, migraines, restless legs syndrome, and asthma. Patients are also at increased risk for suicide.

Patients with this disorder may have an increased risk of various general medical conditions.


F41.0 – Panic disorder [episodic paroxysmal anxiety]

371631005 – Panic disorder

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Differential Diagnosis & Pitfalls

Medical conditions that may mimic panic attacks include:
  • Acute coronary syndrome
  • Coronary artery disease
  • Acute coronary syndrome
  • Cardiac arrhythmias, such as Atrial fibrillation
  • Pulmonary embolism
  • Asthma
  • Hypoglycemia
  • Pheochromocytoma
  • Transient ischemic attacks
  • Seizure disorder (see Seizure)
Mental illnesses that may result in panic attacks or mimic panic disorder include:
  • Generalized anxiety disorder
  • Substance use disorders
  • Phobias, including agoraphobia
  • Schizophrenia spectrum disorders
  • Bipolar disorders
  • Posttraumatic stress disorder
  • Somatic symptom and related disorders

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Last Reviewed:10/09/2019
Last Updated:02/03/2021
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Panic disorder
A medical illustration showing key findings of Panic disorder : Dizziness, Anxiety, Heart palpitations, Diaphoresis, Dyspnea, Presyncope, Recurring episodes
Copyright © 2024 VisualDx®. All rights reserved.