June 2020: The information on the classes of antidepressants suitable for longer-term management of panic disorder was updated to include serotonin-noradrenaline reuptake inhibitors (SNRIs), and give details on the medicines licensed for this treatment.
Medicines and Healthcare products Regulatory Agency (MHRA) warning advice on citalopram and selective serotonin reuptake inhibitors (SSRIs) prescribing was added to recommendations 1.2.6, 1.2.8, 1.4.4 and 1.4.37.
SSRIs licensing information has been added to recommendations 1.2.22 and 1.2.23.
Some recommendations were updated with links to the NICE guideline on supporting adult carers for advice on identifying, assessing and meeting the caring, physical and mental health needs of families and carers. Some recommendations had relevant cross-links updated or added.
These updated recommendations are labelled [2004, amended 2020] or [2011, amended 2020].
July 2019: Because of a risk of abuse and dependence, pregabalin is controlled under the Misuse of Drugs Act 1971 as a class C substance and scheduled under the Misuse of Drugs Regulations 2001 as schedule 3 (as of 1 April 2019). A note has been added in this guideline to reflect this change. Recommendation 1.4.39 was also amended to remove structured problem solving as a care and management option, as this had been originally included in error.
Minor updates since publication
April 2022: We added a link to NICE's guideline on medicines associated with dependence or withdrawal symptoms in sections 1.2 and 1.4.
June 2018: Recommendation 1.2.13 was amended with advice on cognitive behavioural therapy (CBT) to bring it in line with current best practice and other NICE guidance. Recommendation 1.2.26 was updated with a link to the newest evidence on use of antipsychotics for treatment of generalised anxiety disorder. Recommendation 1.4.7 was added to give a link to existing guidance on identifying treatment options for common mental health problems. Recommendation 1.4.10 on low-intensity interventions for mild to moderate panic disorder and 1.4.13 on treatment for moderate to severe panic disorder were added, taken from the NICE guideline on common mental health problems. Recommendations in section 1.4 on stepped care for people with panic disorder were reordered.
About this guideline
Recommendations are marked , [2004, amended 2011], [2004, amended 2020], , [2011, amended 2018],  or [2011, amended 2020] if the evidence has been reviewed.
 indicates that the evidence has not been updated and reviewed since 2004.
[2004, amended 2011] indicates that the evidence has not been updated and reviewed since 2004 but a small amendment has been made to the recommendation.
 indicates that the evidence has been reviewed and the recommendation has been updated or added.
[2011, amended 2018] or  indicates the recommendation was amended in the June 2018 update to bring it in line with current best practice or other NICE guidance, or added to give a link to existing guidance.