Toward a personalized therapy for panic disorder: preliminary considerations from a work in progress

Daniela Caldirola1,2, Giampaolo Perna1–41Humanitas University, 20090 Pieve Emanuele, Milan, Italy; 2Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, 22032 Albese Con Cassano, Como, Italy; 3Department of Psychiatry and Neuropsychology, Facult...

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Autores principales:	Caldirola D, Perna G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	pharmacotherapy somatic evidence-based panic Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/85e69a1cff834444a8b0ae62e00dca6e
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spelling	oai:doaj.org-article:85e69a1cff834444a8b0ae62e00dca6e2021-12-02T06:36:52ZToward a personalized therapy for panic disorder: preliminary considerations from a work in progress1178-2021https://doaj.org/article/85e69a1cff834444a8b0ae62e00dca6e2019-07-01T00:00:00Zhttps://www.dovepress.com/toward-a-personalized-therapy-for-panic-disorder-preliminary-considera-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Daniela Caldirola1,2, Giampaolo Perna1–41Humanitas University, 20090 Pieve Emanuele, Milan, Italy; 2Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, 22032 Albese Con Cassano, Como, Italy; 3Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 Maastricht, The Netherlands; 4Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, Miami University, Miami, FL 33136 -1015, USAAbstract: Although several treatment options for panic disorder (PD) are available, the best intervention for each individual patient remains uncertain and the use of a more personalized therapeutic approach in PD is required. In clinical practice, clinicians combine general scientific information and personal experience in the decision-making process to choose a tailored treatment for each patient. In this sense, clinicians already use a somehow personalized medicine strategy. However, the influence of their interpretative personal models may lead to bias related to personal convictions, not sufficiently grounded on scientific evidence. Hence, an effort to give some advice based on the science of personalized medicine could have positive effects on clinicians’ decisions. Based on a narrative review of meta-analyses, systematic reviews, and experimental studies, we proposed a first-step attempt of evidence-based personalized therapy for PD. We focused on some phenomenological profiles, encompassing symptoms during/outside panic attacks, related patterns of physiological functions, and some aspects of physical health, which might be worth considering when developing treatment plans for patients with PD. We considered respiratory, cardiac, vestibular, and derealization/depersonalization profiles, with related implications for treatment. Given the extensiveness of the topic, we considered only medications and some somatic interventions. Our proposal should be considered neither exhaustive nor conclusive, as it is meant as a very preliminary step toward a future, robust evidence-based personalized therapy for PD. Clearly much more work is needed to achieve this goal, and recent technological advances, such as wearable devices, big data platforms, and the application of machine learning techniques, may help obtain reliable findings. We believe that combining the efforts of different research groups in this work in progress can lead to largely shared conclusions in the near future.Keywords: pharmacotherapy, somatic, evidence-based, panicCaldirola DPerna GDove Medical Pressarticlepharmacotherapysomaticevidence-basedpanicNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1957-1970 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	pharmacotherapy somatic evidence-based panic Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	pharmacotherapy somatic evidence-based panic Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Caldirola D Perna G Toward a personalized therapy for panic disorder: preliminary considerations from a work in progress
description	Daniela Caldirola1,2, Giampaolo Perna1–41Humanitas University, 20090 Pieve Emanuele, Milan, Italy; 2Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, 22032 Albese Con Cassano, Como, Italy; 3Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 Maastricht, The Netherlands; 4Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, Miami University, Miami, FL 33136 -1015, USAAbstract: Although several treatment options for panic disorder (PD) are available, the best intervention for each individual patient remains uncertain and the use of a more personalized therapeutic approach in PD is required. In clinical practice, clinicians combine general scientific information and personal experience in the decision-making process to choose a tailored treatment for each patient. In this sense, clinicians already use a somehow personalized medicine strategy. However, the influence of their interpretative personal models may lead to bias related to personal convictions, not sufficiently grounded on scientific evidence. Hence, an effort to give some advice based on the science of personalized medicine could have positive effects on clinicians’ decisions. Based on a narrative review of meta-analyses, systematic reviews, and experimental studies, we proposed a first-step attempt of evidence-based personalized therapy for PD. We focused on some phenomenological profiles, encompassing symptoms during/outside panic attacks, related patterns of physiological functions, and some aspects of physical health, which might be worth considering when developing treatment plans for patients with PD. We considered respiratory, cardiac, vestibular, and derealization/depersonalization profiles, with related implications for treatment. Given the extensiveness of the topic, we considered only medications and some somatic interventions. Our proposal should be considered neither exhaustive nor conclusive, as it is meant as a very preliminary step toward a future, robust evidence-based personalized therapy for PD. Clearly much more work is needed to achieve this goal, and recent technological advances, such as wearable devices, big data platforms, and the application of machine learning techniques, may help obtain reliable findings. We believe that combining the efforts of different research groups in this work in progress can lead to largely shared conclusions in the near future.Keywords: pharmacotherapy, somatic, evidence-based, panic
format	article
author	Caldirola D Perna G
author_facet	Caldirola D Perna G
author_sort	Caldirola D
title	Toward a personalized therapy for panic disorder: preliminary considerations from a work in progress
title_short	Toward a personalized therapy for panic disorder: preliminary considerations from a work in progress
title_full	Toward a personalized therapy for panic disorder: preliminary considerations from a work in progress
title_fullStr	Toward a personalized therapy for panic disorder: preliminary considerations from a work in progress
title_full_unstemmed	Toward a personalized therapy for panic disorder: preliminary considerations from a work in progress
title_sort	toward a personalized therapy for panic disorder: preliminary considerations from a work in progress
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/85e69a1cff834444a8b0ae62e00dca6e
work_keys_str_mv	AT caldirolad towardapersonalizedtherapyforpanicdisorderpreliminaryconsiderationsfromaworkinprogress AT pernag towardapersonalizedtherapyforpanicdisorderpreliminaryconsiderationsfromaworkinprogress
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Toward a personalized therapy for panic disorder: preliminary considerations from a work in progress

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