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Panic disorder outpatient management — USMLE Step 3 MCQ

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ModeratePsychiatryPanic disorder outpatient managementUSMLE Step 3

A 29-year-old woman has panic attacks twice weekly for 3 months with palpitations, trembling, dyspnea, and fear of dying. ECG, TSH, and CBC are normal. She avoids grocery stores because an attack occurred there. She drinks little caffeine and uses no substances. Which of the following is the most appropriate next step in management?

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Correct answer: E — Start fluoxetine and offer cognitive behavioral therapy

Panic disorder with avoidance is treated with CBT and/or an SSRI/SNRI. Benzodiazepines may be short-term adjuncts in selected patients but are not preferred as sole long-term therapy.

Reference: American Psychiatric Association anxiety disorder treatment guidance