Panic attacks and panic disorders.

The diagnosis and treatment of panic attacks and panic disorders have progressed markedly during the last decade. Unlike phobic disorders, the key feature of panic disorders is the many panic attacks that are mostly spontaneous or not caused by a particular situation. Recent studies linking its pathogenesis with lactate infusion tests are reviewed. For treatment, psychotherapy combined with in vivo exposure and pharmacotherapy is more efficacious than either treatment alone. In most cases, psychological treatment is supportive psychotherapy. The use of imipramine, as reported by Klein et al., is described, and alprazolam is presented as an alternative.