PANIC DISORDER AND ALCOHOLISM

Abstract

We report four patients used alcohol to self-medicate primary panic dis- order and phobias, in whom prolonged alcohol intake and reported withdrawal episodes might have exacerbated and provoked panic attacks. Alcoholism and panic are probably mutually reinforcing, that is, panic may lead to drinking and also result from prolonged use or withdrawal of alcohol. We discuss the interaction of alcohol abuse/dependence with panic disorder, possible causal relationships, biologic relationships, and implications for therapeutic interventions. Possible biologic relationships involve the γ-aminobutyric acid (GABA)-benzodiazepine receptor complex and central noradrenergic system. Cognitive- behavioral psychotherapy is effective as well as medication for treatment.