Panic disorder: guidelines to safe use of benzodiazepines.

Panic disorder is relatively common in older patients and may have serious consequences. The diagnosis is based on an accurate history of symptom onset and intensity. Symptoms include shortness of breath, dizziness, increased heart rate, trembling, and sweating. Effective treatment can be achieved with several kinds of medication, including benzodiazepines. Although physician and patient fears about benzodiazepines persist, panic-disordered patients with no history of drug abuse rarely develop substance dependence problems. Physical dependence occurs in a minority of patients and can be minimized by a slow tapering schedule. As with most medications, benzodiazepines need to be used with caution in older patients, who are more susceptible to adverse effects.