Panic disorder — RACGP Fellowship MCQ

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ModerateMental healthPanic disorderRACGP Fellowship

A 39‑year‑old woman presents with panic attacks occurring in supermarkets. ECG and thyroid function are normal. She now avoids shopping and asks for tablets she can take daily to prevent attacks. What is the most appropriate management?

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Correct answer: A — Offer cognitive behavioural therapy and consider an SSRI

Option A is correct. Australian primary‑care guidance (RACGP) endorses cognitive behavioural therapy as one of the treatments of choice for panic disorder, and recommends SSRIs as the first‑line medication when needed; benzodiazepines are reserved only for short‑term adjunctive use due to risks of dependence and interference with CBT ([racgp.org.au](https://www.racgp.org.au/getattachment/1beeb924-cf7b-4de4-911e-f7dda3e3f6e9/Evidence-based-guidance-for-benzodiazepines.aspx?utm_source=openai)). Option B is not appropriate because long‑term alprazolam carries high risk of dependence and is not recommended. Option E (avoidance) perpetuates agoraphobia and is counter‑therapeutic. Option C (antipsychotics) has no role in panic disorder. Option D is unnecessary given normal ECG and thyroid results; further cardiac testing would delay effective mental health treatment.

Reference: RACGP ‘Prescribing drugs of dependence in general practice – Part B: Benzodiazepines’ (c. 2015) and Australian & New Zealand clinical practice guidelines for panic disorder and agoraphobia (2003) via PubMed