Brazilian Psychiatric Association guidelines for the treatment of panic disorder. An overview of systematic reviews.

Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) Pub Date : 2025-09-05 DOI:10.47626/1516-4446-2025-4349

Leonardo Baldaçara, Diogo de Lacerda Veiga, Luiz Antônio Vesco Gaiotto, Ana Beatriz Paschoal, Aldo Felipe Pinto, Thales Marcon Almeida, Diogo Cesar Dos Santos, Fabiano Franca Loureiro, Leandro Fernandes Malloy-Diniz, Acioly Luiz Tavares Lacerda, Antônio E Nardi, Antônio Geraldo da Silva, Ricardo R Uchida

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引用次数: 0

Abstract

Objective: To develop national evidence-based treatment guidelines for panic disorder (PD) in Brazil through an overview of systematic reviews.

Methods: We searched PubMed, Scielo, and Cochrane for systematic reviews (with or without meta-analyses) of randomized controlled trials for panic disorder (with or without agoraphobia) from 2004 to 2024. Study methodology was assessed using AMSTAR 2 to assess articles and GRADE for the evidence of each outcome. The PICO framework was used to obtain response, remission, and dropout rates. PROSPERO CRD420251002430.

Results: 202 papers were identified, 84 were eligible, and 9 were included (AMSTAR 2 High). Response, remission, and chance of dropout were classified by GRADE. SSRIs, SNRIs, TCAs, MAIOs, CBT, and BT achieve the best response, remission, and tolerability. Combined psychotherapy and antidepressants work well together. Benzodiazepines demonstrated short-term efficacy and tolerability but are not recommended as first-line treatment due to concerns about dependency and long-term risks.

Conclusion: SSRIs, SNRIs, TCAs, and CBT can be endorsed as first-line interventions for panic disorder (PD). Concomitant therapy may provide supplementary advantages. Subsequent investigations ought to concentrate on enduring results and the reduction of bias.

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巴西精神病学协会恐慌症治疗指南。系统综述。

目的：通过系统综述，制定巴西惊恐障碍（PD）的国家循证治疗指南。方法：我们检索PubMed、Scielo和Cochrane，检索2004年至2024年惊恐障碍（伴或不伴广场恐怖症）随机对照试验的系统评价（含或不含荟萃分析）。研究方法学采用AMSTAR 2评估文章和GRADE对每个结果的证据进行评估。PICO框架用于获得缓解率、缓解率和辍学率。普洛斯彼罗CRD420251002430。结果：共筛选论文202篇，符合标准84篇，纳入9篇（AMSTAR 2 High）。反应、缓解和退出的机会按GRADE进行分类。SSRIs、SNRIs、TCAs、maio、CBT和BT达到最佳的反应、缓解和耐受性。心理治疗和抗抑郁药物联合使用效果很好。苯二氮卓类药物显示出短期疗效和耐受性，但由于担心依赖性和长期风险，不推荐作为一线治疗。结论：SSRIs、SNRIs、TCAs和CBT可作为惊恐障碍（PD）的一线干预措施。同时治疗可提供补充优势。随后的调查应该集中在持久的结果和减少偏见。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)

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