[Guest]

Dr.,

I always hear the term "response" used when referring to treatment of Panic Disorder and other Psychiatric disorders. I understand it to be defined as a 50% reduction in symptoms. However, this a very vague definition for practical purposes and doesn't seem to set the bar very high. I have three questions:

1. In layman's terms, what would a practical definition of response be in Panic Disorder as it relates to daily functioning?

2. If one "responds" to medications, they would still be clearly sypmtomatic using the 50% approach to response. How then does that person progress to remission? It would appear to me that if a person responds, but does not remit, there would not be much point in tapering medication, the disorder is clearly still present and most likely, still quite bothersome.

3. Once "response" is achieved (assuming it is achieved within a normal timeframe of 4-8 weeks), do further improvements occur over time, or is the maximum benefit of the medication now shown, and if remission has not occured it is not likely to based solely on the current medication and dosage?

Thanks as always.

[Guest]

You continue to improve untill about eight weeks after any given dosage change. Then "what you see is what you get". The doctor and patient discuss if it is "good enough" and were to go from there. There is the option to "wait and see", change agents, increase the dose, or augment with another agent. What happens depends upon the first experience. In terms of what is "good enough" to consider to be a remission, that really is a highly subjective matter. The doctor and patient need to discuss it.
[quote] Dr. ,

I always hear the term "response" used when referring to treatment of Panic Disorder and other Psychiatric disorders... [/quote]