简单认知行为心理疗法 (CBT) 干预
调查显示，5次CBT治疗即对惊恐障碍有益。[114]Otto MW, Tolin DF, Nations KR, et al. Five sessions and counting: considering ultra-brief treatment for panic disorder. Depress Anxiety. 2012 Jun;29(6):465-70.http://www.ncbi.nlm.nih.gov/pubmed/22730311?tool=bestpractice.com 并在急诊科为惊恐障碍患者提供 1 次 CBT 干预治疗。[115]Lessard MJ, Marchand A, Pelland MÈ, et al. Comparing two brief psychological interventions to usual care in panic disorder patients presenting to the emergency department with chest pain. Behav Cogn Psychother. 2012 Mar;40(2):129-47.http://www.ncbi.nlm.nih.gov/pubmed/21929830?tool=bestpractice.com 对于有惊恐障碍的青少年，8天强化CBT项目能有效降低惊恐和共病焦虑障碍的症状。[116]Gallo KP, Chan PT, Buzzella BA, et al. The impact of an 8-day intensive treatment for adolescent panic disorder and agoraphobia on comorbid diagnoses. Behav Ther. 2012 Mar;43(1):153-9.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510263/http://www.ncbi.nlm.nih.gov/pubmed/22304887?tool=bestpractice.com
心理健康应用程序
已开发出部分心理健康应用程序，用于治疗与惊恐和焦虑相关的疾病。智能手机执行的干预措施具有以低成本达到大规模传播的潜在益处。遗憾的是，许多可获取的应用程序缺乏关于有效性和疗效的实证性证据。一项荟萃分析显示，相对于对照干预，使用应用程序可减少焦虑的一般症状，[117]Firth J, Torous J, Nicholas J, et al. Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials. J Affect Disord. 2017 Aug 15;218:15-22.https://www.sciencedirect.com/science/article/pii/S0165032717300150http://www.ncbi.nlm.nih.gov/pubmed/28456072?tool=bestpractice.com 但惊恐专用应用程序的质量较差。[118]Van Singer M, Chatton A, Khazaal Y. Quality of smartphone apps related to panic disorder. Front Psychiatry. 2015 Jul 14;6:96.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500864/http://www.ncbi.nlm.nih.gov/pubmed/26236242?tool=bestpractice.com
基于互联网和计算机化的自我帮助
对于无法获得医生治疗的惊恐障碍的患者，开发了基于互联网的自我帮助项目，以便帮助患者更好获得关于惊恐症状的循证治疗原则。 虽然一项系统综述显示自我帮助项目效果已经确定，[119]Carlbring P, Bohman S, Brunt S, et al. Remote treatment of panic disorder: a randomized trail of internet-based cognitive behavior therapy supplemented with telephone calls. Am J Psychiatry. 2006 Dec;163(12):2119-25.http://www.ncbi.nlm.nih.gov/pubmed/17151163?tool=bestpractice.com[120]Cuijpers P, Marks IM, van Straten A, et al. Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cogn Behav Ther. 2009;38(2):66-82.http://www.ncbi.nlm.nih.gov/pubmed/20183688?tool=bestpractice.com 但仍需要长期结果试验评估其效果。[121]Hedman E, Ljótsson B, Lindefors N. Cognitive behavior therapy via the Internet: a systematic review of applications, clinical efficacy and cost-effectiveness. Expert Rev Pharmacoecon Outcomes Res. 2012 Dec;12(6):745-64.http://www.ncbi.nlm.nih.gov/pubmed/23252357?tool=bestpractice.com 具有治疗协调性支持的计算机化 CBT 对治疗惊恐障碍有帮助。[59]Rollman BL, Herbeck Belnap B, Abebe KZ, et al. Effectiveness of online collaborative care for treating mood and anxiety disorders in primary care: a randomized clinical trial. JAMA Psychiatry. 2018 Jan 1;75(1):56-64.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5833533/http://www.ncbi.nlm.nih.gov/pubmed/29117275?tool=bestpractice.com 免费可用资源包括来源于 Anxieties.com 的资源。Anxieties.com
抗惊厥药物
加巴喷丁临床上可以用于惊恐障碍的患者。[122]Pande AC, Pollack MH, Crockatt J, et al. Placebo-controlled study of gabapentin treatment of panic disorder. J Clin Psychopharmacol. 2000 Aug;20(4):467-71.http://www.ncbi.nlm.nih.gov/pubmed/10917408?tool=bestpractice.com 普瑞巴林和拉莫三嗪也已用于焦虑障碍患者，[123]Mula M, Pini S, Cassano GB. The role of anticonvulsant drugs in anxiety disorders: a critical review of the evidence. J Clin Psychopharmacol. 2007 Jun;27(3):263-72.http://www.ncbi.nlm.nih.gov/pubmed/17502773?tool=bestpractice.com 然而，尚不清楚该药在治疗惊恐障碍方面的作用。
新型抗抑郁剂
一项 2013 年的 meta 分析表明，与减轻惊恐障碍患者的惊恐症状相比，米氮平对降低其焦虑程度更有效。[68]Andrisano C, Chiesa A, Serretti A. Newer antidepressants and panic disorder: a meta-analysis. Int Clin Psychopharmacol. 2013 Jan;28(1):33-45.http://www.ncbi.nlm.nih.gov/pubmed/23111544?tool=bestpractice.com 米氮平具有特定人群希望发生的独特副作用特征。[124]Croom KF, Perry CM, Plosker GL. Mirtazapine: a review of its use in major depression and other psychiatric disorders. CNS Drugs. 2009;23(5):427-52.http://www.ncbi.nlm.nih.gov/pubmed/19453203?tool=bestpractice.com[125]Serretti A, Chiesa A, Calati R, et al. Novel antidepressants and panic disorder: evidence beyond current guidelines. Neuropsychobiology. 2011;63(1):1-7.http://www.karger.com/Article/Pdf/321831http://www.ncbi.nlm.nih.gov/pubmed/20962541?tool=bestpractice.com
