Little research has examined the treatment of panic disorder when it co-occurs with AOD use disorders. In the absence of this evidence, the use of similar strategies to those found to be efficacious in the treatment of panic disorder alone is appropriate. The UK NICE guidelines for the management of panic disorder recommend a process of assessment and shared decision making to decide the first line of treatment, which should be psychotherapy (CBT), self-help, or pharmacotherapy (SSRI or TCA antidepressants) [711]. A Cochrane review and meta-analysis have both concluded that, in the treatment of panic disorder alone, it is equally efficacious to use psychotherapy or pharmacotherapy (SSRIs in particular), and that client preference should be taken into account when deciding on a course of treatment [712, 721]. Furthermore, it appears that the combination of psychotherapy and antidepressants is superior to treatment with antidepressants alone [713]. Behavioural techniques such as exposure and systematic desensitisation have also been shown to be effective, and relaxation and supportive counselling may also be helpful [263]. However, it remains unclear as to whether the same approach for treating panic disorder as a single disorder is equally efficacious in the treatment of comorbid panic disorder and AOD use disorders.