Article February 1, 1997

Toward an Integrated Neurobiology of Panic Disorder

Andrew W. Goddard, M.D.; Dennis S. Charney, M.D.

J Clin Psychiatry 1997;58(suppl 2):4-11

Article Abstract

Panic disorder is a common psychiatric illness that causes considerable short- and long-term morbidity.Although drug treatment and cognitive behavior therapy are beneficial, the etiology of panicdisorder and the mechanisms of effective treatment remain unclear. Developments in the preclinicalneuroanatomy and neurophysiology of neuronal structures relevant to fear and anxiety promise to providefresh insights into the neurobiology of panic. In this article, we propose a functional neuroanatomicmodel of fear and anxiety and review brain imaging studies of panic disorder with thismodel in mind. In addition, we discuss the implications of integrating functional neuroanatomy andthe clinical neurochemistry of panic disorder. An integrated neurobiology of panic disorder will providea broader conceptual framework with which to tackle the complex questions about the pathophysiologyand treatment of this condition.