Table 1.

Proposed implications for evidence-based treatment in phenomenological profiles of PD

Phenomenological profilea	Proposed implications for treatment
Respiratory profile
Prominent RSs during/outside PAs. ↑Behavioral/respiratory sensitivity to 35% CO2/65% O2 challenge. Abnormalities in respiratory patterns: ↓end-tidal pCO2, respiratory irregularity, ↓HCO3−/PO4− hematic levels. Presence of current smoking. Presence of current/lifetime asthma/COPD.	Pharamacological treatments to reduce PAs: among SSRIs, paroxetine/sertaline; among TCAs, clomipramine; among BDZs, clonazepam. Noradrenergic compounds not recommended. Somatic treatments to reduce PAs: BRT, aerobic exercise, quitting smoking programs.
Cardiac profile
Prominent CSs during/outside PAs. Abnormalities in cardiac/autonomic patterns: ↓HRV, impaired circardian BP pattern, ECG abnormalities. Low cardiopulmonary fitness, exercise avoidance. Presence of current/lifetime CDs. Presence of current smoking. Presence of additional CVRFs: ↑CRP, ↑PDW, ↑MPV, ↑RDW, ↑cholesterol, ↑homocysteine.	No data about preferential clinical responses to medications. Medications with more favorable profile on cardiac function: paroxetine, sertraline (with regular monitoring of cholesterol levels). TCAs not recommended. Clonazepam: caution in Is-PD with ↓HRV. Somatic treatments: aerobic exercise; healthy dietary patterns (Mediterranean diet, omega 3-fatty acids/probiotics), quitting smoking programs, BRT.
Vestibular profile
Prominent VSs during/outside PAs. Abnormalities in balance system function: impaired postural control, ↑sensitivity to visual-vestibular patterns.	Pharamacological treatments: citalopram, sertraline, imipramine (clinical observations). Somatic treatments: vestibular rehabilitation.
Derealization/Depersonalization profile
Prominent D/DSs during/outside PAs EEG abnormalities.	No data about preferential clinical responses to medications. In case of EEG abnormalities: evaluate the opportunity of using clonazepam/anticonvulsants.

Note: ^aThe higher the number of features, the higher the prominence of the phenomenological profile.

Abbreviations: BDZs, benzodiazepines; BP, blood pressure; BRT, breathing therapy; CDs, cardiac diseases; CO₂, carbon dioxide; COPD, chronic obstructive pulmonary disease; CRP, C-reactive protein; CVRFs, cardiovascular risk factors; CSs, cardiac symptoms; D/DSs, derealization/depersonalization symptoms; ECG, electrocardiogram; EEG, electroencephalogram; HCO₃⁻, bicarbonate; HRV, heart rate variability; Is-PD, individuals suffering from panic disorder; MPV, mean platelet volume; O₂, oxygen; PAs, panic attacks; pCO₂, partial pressure CO₂; PD, panic disorder; PDW, platelet distribution width; PO₄⁻, phosphate; RDW, red cell distribution width; RSs, respiratory symptoms; SNRIs, serotonin–norepinephrine reuptake inhibitor; SSRIs, selective serotonin reuptake inhibitors; TCAs, tricyclic antidepressants; VSs, vestibular symptoms; ↑, high; ↓, low.