American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended treatment for panic disorder?

1. Only medication

2. Cognitive-behavioral therapy alone

3. Combination of cognitive-behavioral therapy and medication

4. Support groups and counseling

The correct answer is: Combination of cognitive-behavioral therapy and medication

The combination of cognitive-behavioral therapy (CBT) and medication is widely recognized as the most effective treatment for panic disorder. CBT is specifically designed to help patients understand and challenge the thought patterns and behaviors that contribute to their panic attacks while also teaching them coping mechanisms to manage anxiety. Medications, particularly selective serotonin reuptake inhibitors (SSRIs) and sometimes benzodiazepines, can be helpful in reducing the acute symptoms of panic attacks and addressing the underlying biochemical imbalances associated with anxiety disorders. Using both CBT and medication together often yields better outcomes than either treatment alone, as they complement each other: CBT provides tools to address thoughts and behaviors, while medication can help stabilize neurotransmitter levels that may exacerbate anxiety. In comparison, focusing solely on medication may not address the cognitive and behavioral aspects of panic disorder, which can lead to ongoing symptoms or relapse. While CBT alone can be quite effective, many patients benefit from the additional support that medication provides, especially if their symptoms are severe. Support groups and counseling can be beneficial adjuncts to treatment; however, they are generally not considered primary treatments for panic disorder. Hence, the combination of CBT and medication is the most robust and well-supported approach for effectively managing panic disorder.