Impact of pregnancy on panic disorder: a case series.
BACKGROUND
Pregnancy has a variable impact on the course of panic disorder. Some patients describe diminished anxiety symptoms during pregnancy, while others note persistence or worsening of symptoms.


METHODS
We retrospectively evaluated the clinical course of 49 women with pregravid panic disorder across three trimesters of pregnancy and evaluated the extent to which severity of pregravid panic disorder predicted course of anxiety symptoms, medication received, and ability to discontinue medication during pregnancy.


RESULTS
While 38 women (78%) were noted either to have insignificant change in status or to have clinical improvement, 10 women (20%) evinced more severe panic symptoms during pregnancy. More severely ill women received pharmacotherapeutic intervention during some portion of their pregnancy compared with less severely ill women. Pregnancy did not increase the likelihood of successful discontinuation from antipanic medication.


CONCLUSIONS
Impact of pregnancy on panic disorder is variable. Some patients, particularly those with milder symptoms, may improve during this time; more severely ill women may constitute a subgroup at risk for persistence of underlying disease and with a need for continued treatment with antipanic medication.
Cohen
L S
LS
Department of Psychiatry, Massachusetts General Hospital, Boston 02114.
Sichel
D A
DA
Dimmock
J A
JA
Rosenbaum
J F
JF
D000553:Ambulatory Care; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016584:Panic Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011336:Probability; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents