Clomipramine Treatment of Panic Disorder

Papp, Laszlo A.; Schneier, F.; Fyer, Abby J.; Leibowitz, Morton; Gorman, Jack M.; Coplan, Jeremy D.; Campeas, Raphael; Fallon, Brian A.; Klein, D F

doi:10.4088/jcp.v58n1002

Cited by 23 publications

(8 citation statements)

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“…These include the SSRIs (citalopram, fluvoxamine, fluoxetine, paroxetine, sertraline) (Bakker et al 2002 ;Hoehn-Saric et al 1993 ;Michelson et al 1998 ;Pollack et al 1998 ;Stahl et al 2003 ;Wade et al 1997), the TCAs imipramine and clomipramine (CNCPS, 1992 ;Papp et al 1997), the SNRI venlafaxine (Bradwejn et al 2005 ;Liebowitz et al 2009 ;Pollack et al 2007a, b), and the irreversible MAOI phenelzine (Sheehan et al 1980 ;Tyrer et al 1973). These include the SSRIs (citalopram, fluvoxamine, fluoxetine, paroxetine, sertraline) (Bakker et al 2002 ;Hoehn-Saric et al 1993 ;Michelson et al 1998 ;Pollack et al 1998 ;Stahl et al 2003 ;Wade et al 1997), the TCAs imipramine and clomipramine (CNCPS, 1992 ;Papp et al 1997), the SNRI venlafaxine (Bradwejn et al 2005 ;Liebowitz et al 2009 ;Pollack et al 2007a, b), and the irreversible MAOI phenelzine (Sheehan et al 1980 ;Tyrer et al 1973).…”

Section: Efficacy In Acute Phase Treatmentmentioning

confidence: 99%

Evidence-based pharmacotherapy of panic disorder: an update

Batelaan

Balkom

Stein

2011

Int. J. Neuropsychopharm.

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The evidence-based pharmacotherapy of panic disorder continues to evolve. This paper reviews data on first-line pharmacotherapy, evidence for maintenance treatment, and management options for treatment-refractory patients. A Medline search of research on pharmacotherapy was undertaken, and a previous systematic review on the evidence-based pharmacotherapy of panic disorder was updated. Selective serotonin reuptake inhibitors remain a first-line pharmacotherapy of panic disorder, with the serotonin noradrenaline reuptake inhibitor venlafaxine also an acceptable early option. Temporary co-administration of benzodiazepines can be considered. Maintenance treatment reduces relapse rates, but further research to determine optimal duration is needed. For patients not responding to first-line agents several pharmacotherapy options are available, but there is a notable paucity of data on the optimal choice.

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Section: Efficacy In Acute Phase Treatmentmentioning

confidence: 99%

Evidence-based pharmacotherapy of panic disorder: an update

Batelaan

Balkom

Stein

2011

Int. J. Neuropsychopharm.

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“…A number of randomized controlled trials have demonstrated the effectiveness of venlafaxine immediate-release (IR) and ER formulations for the treatment of major depression, [Smith et al, 2002;Thase et al, 2001], generalized anxiety disorder [GAD; Allgulander et al, 2001;Gelenberg et al, 2000;Rickels et al, 2000], and social anxiety disorder [Allgulander et al, 2004;Liebowitz et al, 2005a,b;Rickels et al, 2004]. Small open-label and double-blind studies of venlafaxine IR have suggested that it is also effective in the treatment of panic disorder [Geracioti, 1995;Papp et al, 1998;Pollack et al, 1996]. In the current randomized, placebo-controlled trial, we compared venlafaxine ER with the established antipanic agent paroxetine in the treatment of panic disorder with or without agoraphobia.…”

Section: Introductionmentioning

confidence: 99%

A double-blind study of the efficacy of venlafaxine extended-release, paroxetine, and placebo in the treatment of panic disorder

Pollack¹,

Lepola²,

Koponen³

et al. 2006

Depress. Anxiety

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To date, no large-scale, controlled trial comparing a serotonin-norepinephrine reuptake inhibitor and selective serotonin reuptake inhibitor with placebo for the treatment of panic disorder has been reported. This double-blind study compares the efficacy of venlafaxine extended-release (ER) and paroxetine with placebo. A total of 664 nondepressed adult outpatients who met DSM-IV criteria for panic disorder (with or without agoraphobia) were randomly assigned to 12 weeks of treatment with placebo or fixed-dose venlafaxine ER (75 mg/day or 150 mg/ day), or paroxetine 40 mg/day. The primary measure was the percentage of patients free from full-symptom panic attacks, assessed with the Panic and Anticipatory Anxiety Scale (PAAS). Secondary measures included the Panic Disorder Severity Scale, Clinical Global Impressions-Severity (CGI-S) andImprovement (CGI-I) scales; response (CGI-I rating of very much improved or much improved), remission (CGI-S rating of not at all ill or borderline ill and no PAAS full-symptom panic attacks); and measures of depression, anxiety, phobic fear and avoidance, anticipatory anxiety, functioning, and quality of life. Intent-to-treat, last observation carried forward analysis showed that mean improvement on most measures was greater with venlafaxine ER or paroxetine than with placebo. No significant differences were observed between active treatment groups. Panic-free rates at end point with active treatment ranged from 54% to 61%, compared with 35% for placebo. Approximately 75% of patients given active treatment were responders, and nearly 45% achieved remission. The placebo response rate was slightly above 55%, with remission near 25%. Adverse events were mild or moderate and similar between active treatment groups. Venlafaxine ER and paroxetine were effective and well tolerated in the treatment of panic disorder.

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“…Other agents used in the management of panic disorder. The TCAs clomipramine and imipramine are efficacious agents in the treatment of PD (Klerman, 1992;Lecrubier, Judge, & the Collaborative Paroxetine Panic Study Investigators, 1997;Papp et al, 1997). As noted previously for other anxiety disorders, their side effect profiles and potential toxicity in overdose precludes them from being first-line agents.…”

Section: Panic Disordermentioning

confidence: 99%