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Abstract
The purpose of this article is to review the literature concerning the interaction
of alcohol and/or substance abuse with panic disorder, the comorbidity of these disorders,
possible causal relationships, biologic relationships, and the recognition and treatment
of dually disordered patients. A number of studies suggest significant comorbidity
between panic disorder and alcoholism or abuse of drugs, especially cocaine and sedatives.
Panic may lead to drinking or sedative use and also result from prolonged use or withdrawal
of alcohol or other drugs. Possible biologic relationships involve the γ-aminobutyric
acid (GABA)benzodiazepine receptor complex and the central noradrenergic system. Although
treatment of panic in substance abusers has not been studied specifically, guidelines
for recognition and management of these patients, including use of antipanic medication,
are discussed.
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© 1992 Published by Elsevier Inc.
