Clomipramine, a better reference drug for panic/agoraphobia. II. Psychomotor and cognitive effects

Abstract

The present reference drugs for the treatment of panic disorder and agoraphobia are imipramine and alprazolam. The latter decreases performance and cognitive functioning. No study of such functions in panic/agoraphobia is available. Fifty four out-patients meeting DSM-III-R criteria for panic disorder with or without agoraphobia (PAG), taking part in a parallel groups controlled trial of imipramine (mean dose ±SEM 114±9 mg), clomipramine (50±4 mg) and propanteline (active placebo) over 8 weeks, were studied. A test battery of psychomotor and memory tests was administered at baseline, and after 1, 4 and 8 weeks of treatment. Their results were compared (at baseline and at the end of the trial) with those of a control group of 57 normal untreated subjects. There was no difference between treatments, and no drug effect on any test at any time. No consistent difference between patients and controls was detected. Given its apparently higher potency, and the absence of deleterious effects on cognitive measures known to be affected by benzodiazepines, we conclude that clomipramine is better than imipramine or alprazolam as a reference drug for panic/agoraphobia.

A two-dimensional neuropsychology of defense: fear/anxiety and defensive distance

“…[139] c Ref. [94] analysed by the Blanchards). Intermediate defensive distances can be equated with phobic avoidance.…”

Effect of Chronic Treatment with Clomipramine on Food Intake, Macronutrient Selection and Body Weight Gain in Rats

“…The development of animal models is crucial to investigate the underlying neural mechanisms involved the weight gain produced by antidepressants drugs. Clomipramine was chosen for the present study due to the following reasons: (i) it has high potential to induce weight gain 2) ; (ii) it is a reference drug for treatment of emotional disorders such as obsessive-compulsive disorder and panic disorder 23) and (iii) it has been widely used for treatment of psychiatric disorders as well as in clinical researches in Brazil [24][25][26][27][28] and recent evidence from our research group has indicated that CMI induces weight gain in healthy volunteers (results not published). Long-term treatment with clomipramine (CMI), a tricyclic antidepressant, induces food craving and body weight gain in patients.…”

Cognitive performance in depressed patients after chronic use of antidepressants

“…No significant drug effects were observed after 8 weeks of treatment with clomipramine (mean dose 50 mg/day), imipramine (mean dose 114 mg/day) and active placebo (Marcourakis et al 1993). In a subsequent study, we evaluated the consequences of chronic use (around 6 years) of therapeutic doses of clomipramine (mean dose 57 mg/day) on remitted out-patients with panic disorder/agoraphobia compared to healthy volunteers matching the patients' characteristics (Carvalho et al 2002).…”