A 27-year-old man presents to the emergency department with his third episode of acute-onset palpitations, chest discomfort, and a sensation of impending doom over the past 2 months. Each episode peaks within 10 minutes and is accompanied by diaphoresis, trembling, dyspnea, and paresthesias in his hands and feet. He reports feeling as though he is dying during these episodes. Between episodes, he feels well. His vital signs during the episode are: temperature 37.2°C, heart rate 102/min, blood pressure 138/84 mmHg, respiratory rate 22/min. Physical examination is otherwise unremarkable. A 12-lead ECG, troponin level, and complete metabolic panel are all within normal limits. He denies use of illicit drugs, excessive caffeine, or alcohol. He has no significant medical or psychiatric history and reports normal interpersonal relationships. Which of the following is the most appropriate initial management?

1. A)Selective serotonin reuptake inhibitor plus cognitive behavioral therapyGABARITO
2. B)Alprazolam 0.5 mg three times daily for 12 months
3. C)Metoprolol 25 mg twice daily as monotherapy
4. D)24-hour Holter monitor and stress testing
5. E)Reassurance and scheduled follow-up in 3 months