Dizziness and panic disorder: a review of the association between vestibular dysfunction and anxiety

Ann Clin Psychiatry. 1998 Jun;10(2):75-80. doi: 10.1023/a:1026167000066.

Abstract

Dizziness is a common and costly condition that causes significant distress and impairment yet often confounds appropriate diagnosis and treatment. Among patients presenting for evaluation and treatment of dizziness, rates of panic disorder are elevated to 5 to 15 times the general population rates. In addition, the limited studies to date of dizziness in patients with panic disorder suggest that panic patients frequently experience significant dizziness and often demonstrate evidence of vestibular dysfunction. In this paper we review studies investigating the relationship between panic disorder and vestibular dysfunction. Currently, there are three main explanatory models for the association between panic disorder and vestibular dysfunction: the psychosomatic model, the somatopsychic model, and the network alarm theory. Systematic investigations of the treatment of patients with vestibular symptoms and panic disorder are lacking, though prevalence, associated costs, and disability suggest that they are needed. Serotonin selective reuptake inhibitors are good candidates for future treatment studies.

Publication types

  • Review

MeSH terms

  • Agoraphobia / complications
  • Agoraphobia / physiopathology
  • Anti-Anxiety Agents / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Anxiety / physiopathology*
  • Benzodiazepines
  • Dizziness / complications
  • Dizziness / physiopathology*
  • Dizziness / psychology
  • Humans
  • Models, Psychological
  • Panic Disorder / complications
  • Panic Disorder / drug therapy
  • Panic Disorder / physiopathology*
  • Psychophysiologic Disorders / classification
  • Somatoform Disorders / classification
  • Vestibular Diseases / complications*
  • Vestibular Diseases / physiopathology
  • Vestibular Diseases / psychology

Substances

  • Anti-Anxiety Agents
  • Antidepressive Agents
  • Benzodiazepines