The treatment of panic disorder during pregnancy and lactation poses special problems. It is important that both the practitioner and patient consider a number of issues to find the most appropriate treatment for the patient. New cognitive-behavioural treatment options often circumvent the problems of pharmacotherapy for pregnant or lactating women while providing therapeutic benefits which are at least equivalent.
References
1.
Diagnostic and statistical manual of mental disorders, third edition, revised.Washington DC: American Psychiatric Press, Inc., 1987.
2.
MogulKM. Psychological considerations in the use of psychotropic drugs with women patients. Hosp Community Psychiatry1985; 36: 1080–1085.
3.
CowleyDS, Roy-ByrnePP. Panic disorder during pregnancy. Journal of Psychosomatic Obstetrics Gynaecology1989; 10: 193–210.
4.
MortolaJF. The use of psychotropic agents in pregnancy and lactation. Psychiatr Clin North Am1989; 12: 69–87.
5.
Roy-ByrneP, KatonW.An update on treatment of the anxiety disorders. Hosp Community Psychiatry1987; 38: 835–843.
6.
KloskoJS, BarlowDH, TassinariRB, A comparison of alprazolam and cognitive behavior therapy in the treatment of panic disorder. J Consult Clin Psychol1990; 58: 77–84.
7.
BallengerJC, BurrowsGD, DuPontRL, Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. Arch Gen Psychiatry1988; 45: 413–422.
8.
FyerAJ, SandbergD, KleinDF. Pharmacological treatment of panic disorder and agoraphobia. In: WalkerJR, NortonGR, RossCA, eds. Panic disorder and agoraphobia: a comprehensive guide for the practitioner.Pacific Grove CA: Brooks/Cole, 1991.
9.
ClumGA. Psychological interventions vs drugs in the treatment of panic. Behavior Therapy1989; 20: 429–457.
10.
PecknoldJC. Behavioral and combined therapy in panic states. Prog Neuropsychopharmacol Biol Psychiatry1987; 11: 97–104.
11.
MarksIM, MathewsAM. Brief standard self-rating for phobic patients. Behav Res Ther1979; 17: 263–267.
12.
ClarkDM. A cognitive approach to panic. Behav Res Ther1986; 24: 461–470.
13.
GeorgeD, LadenheimJ, NuttD.Effect of pregnancy on panic attacks. Am J Psychiatry1987; 144: 1078–1079.
14.
BarlowDH, CernyJA. Psychological treatment of panic.New York: The Guilford Press, 1988.