Diagnosis: Panic disorder Treatment Plan and Notes: The patient, E.R., a 12-year-old female, was brought to the clinic by her mother due to increased anxiety and symptoms of panic attacks.

 Diagnosis: Panic disorder
Treatment Plan and Notes:
The patient, E.R., a 12-year-old female, was brought to the clinic by her mother due to increased anxiety and symptoms of panic attacks. The mother reports that E.R. has been experiencing growing anxiety and occasionally has episodes of rapid heartbeats accompanied by increased sweating. Today, she had a panic-like attack as she sweat uncontrollably and her heartbeat increased, which led her mother to bring her to the clinic.

Throughout the visit, E.R. appeared visibly anxious and distressed and usually could talk of things that were not in existence in real life, indicating her disconnection with reality. Vital signs were taken and revealed an increased heart rate of 110 beats per minute and mild sweating. E.R. appeared tense and had difficulty maintaining eye contact throughout the evaluation period. She did not have any physical abnormalities as per the concluded examination. The symptoms and the observed signs were consistent with anxiety disorder. After the symptoms, signs, and health history were reviewed against the DSM-5 TR, E.R. was specifically diagnosed with a mild panic disorder.

The available treatment options, including the side effects of each option, were discussed with the parent. The mother gave her consent to proceed with the treatment, and a combined drug therapy, including fluoxetine and olanzapine, was selected. The dosage was started at fluoxetine 20 mg and olanzapine 2.5 mg to be taken orally once daily in the evening. A follow-up is suggested in which observations will be made, and the decision to increase or decrease the dosage will be determined by the symptoms presented after 14 days. E.R. and her mother were educated on anxiety and panic attacks and how these can be managed. E.R. was also referred to a private child psychiatrist for further assessment and management using psychotherapy. Top of For