Document Detail


Challenges in management of complex panic disorder in a palliative care setting.
MedLine Citation:
PMID:  23047995     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
This is a complex case of post-traumatic stress disorder (PTSD) with comorbid panic disorder occurring in a woman in her mid-60s, with a family history of neurotic illness. PTSD arose in the context of treatment for terminal lung cancer. This patient who had been close to her father watched him die of cancer, when he was about her age. Her diagnosis and treatment prompted traumatic recollections of her father's illness and death that resulted in her voluntary withdrawal from cancer treatment. The goals of treatment were to promptly reduce anxiety, minimise use of sedating pharmacotherapy, promote lucidity and prolong anxiety-free state thereby allowing time for important family interactions. Prompt, sustained relief of severe anxiety was necessary to achieve comfort at the end of life. Skilled additions of psychological therapies (eye movement desensitisation reprocessing, clinical hypnosis and breathing exercises) with combined pharmacotherapy (mirtazepine and quetiapine) led to control of anxiety and reduction of post-traumatic stress.
Authors:
Itoro Udo; Amanda Gash
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Publication Detail:
Type:  Journal Article     Date:  2012-10-09
Journal Detail:
Title:  BMJ case reports     Volume:  2012     ISSN:  1757-790X     ISO Abbreviation:  BMJ Case Rep     Publication Date:  2012  
Date Detail:
Created Date:  2012-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101526291     Medline TA:  BMJ Case Rep     Country:  England    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  IM    
Affiliation:
Liaison Psychiatry, Roseberry Park Hospital, Tees, Esk, Wear Valleys NHS Foundation Middlesbrough Trust, UK.
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