Guidance
Update information
June 2020: The information on the classes of antidepressants suitable for longer-term management of panic disorder was updated to include serotonin-noradrenaline reuptake inhibitors (SNRIs), and give details on the medicines licensed for this treatment. Medicines and Healthcare products Regulatory Agency (MHRA) warning advice on citalopram and selective serotonin reuptake inhibitors (SSRIs) prescribing was added to relevant recommendations. SSRIs licensing information was added to relevant recommendations.
July 2019: Because of a risk of abuse and dependence, pregabalin is controlled under the Misuse of Drugs Act 1971 as a class C substance and scheduled under the Misuse of Drugs Regulations 2001 as schedule 3 (as of 1 April 2019). A note has been added in this guideline to reflect this change. Recommendation 1.3.38 was amended to remove structured problem solving as a care and management option, as this had been originally included in error.
Minor changes since publication
May 2024: We have simplified the guideline by removing recommendations on general principles of care that are covered in other NICE guidelines (for example, the NICE guideline on service user experience in adult mental health).
This is a presentational change only, and no changes to practice are intended.
We have also incorporated relevant recommendations from the NICE guideline on common mental health disorders, covering identification (see recommendation 1.2.2) and preventing relapse (see recommendation 1.2.48). These recommendations are marked [2011].
July 2022: We added a link to the MHRA safety advice on pregabalin in pregnancy to recommendation 1.2.25.
June 2018: Recommendation 1.2.14 was amended with advice on cognitive behavioural therapy (CBT) to bring it in line with current best practice and other NICE guidance. Recommendation 1.2.27 was updated with a link to the newest evidence on use of antipsychotics for treatment of generalised anxiety disorder. Recommendation 1.3.10 on low-intensity interventions for mild to moderate panic disorder and 1.3.13 on treatment for moderate to severe panic disorder were added, taken from the NICE guideline on common mental health problems. Recommendations in section 1.2 on stepped care for people with panic disorder were reordered.
Recommendations marked [date 1, amended date 2] had an evidence review in date 1. The amended date means the intent of the recommendation has been changed without an evidence review.
ISBN: 978-1-4731-2854-5