Fluvoxamine in the treatment of panic disorder: a multi-center, double-blind, placebo-controlled study in outpatients

Asnis, Gregory M.; Hameedi, Faiq; Goddard, Andrew W.; Potkin, Steven G.; Black, Donald W.; Jameel, Mustaq; Desagani, Kishore; Woods, Scott W.

doi:10.1016/s0165-1781(01)00265-7

Cited by 63 publications

(34 citation statements)

References 44 publications

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“…Escitalopram is the S-enantiomer of the racemate citalopram; therefore the clinical studies with citalopram may also be relevant for escitalopram (A). Á Fluvoxamine showed efficacy in a number of DBPC studies (Asnis et al 2001;Black et al 1993;de Beurs et al 1995;den Boer and Westenberg 1990;Hoehn-Saric et al 1993;Pols et al 1993). In one study, fluvoxamine and the comparator imipramine were both more effective than placebo and equally effective .…”

Section: Panic Disorder and Agoraphobiamentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

718

410

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In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo-or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/ SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

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Section: Panic Disorder and Agoraphobiamentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

718

410

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“…Mean total SDS scores at baseline were available for 12 of the 37 studies including three panic studies (HoehnSaric et al, 1993;Sheehan et al, 1993;Asnis et al, 2001), three SAD studies Davidson et al, 2004;Westenberg et al, 2004), three GAD studies (Pollack et al, 2001;Rickels et al, 2003;Allgulander et al, 2006), two PTSD studies (Tucker et al, 2001;Davidson et al, 2005), and one MDD study (Smeraldi, 1998). As shown in Fig.…”

Section: Baseline Functioningmentioning

confidence: 99%

Assessing treatment effects in clinical trials with the Discan metric of the Sheehan Disability Scale

Sheehan¹,

Sheehan²

2008

International Clinical Psychopharmacology

379

288

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The Sheehan Disability Scale (SDS) is a patient-rated, discretized analog measure of functional disability in work, social, and family life. Its increasing use in clinical trials in psychiatry suggests a need to assess its responsiveness and interpretability. In this paper we identify and review studies in which the SDS was used as a treatment outcome measure. Our objectives are (i) to evaluate the sensitivity of the SDS to treatment effects and (ii) to examine potential thresholds or cutoff scores for remission and response. Studies for the review were retrieved from the National Library of Medicine's PubMed database (1966 to 21 March 2007) and other sources. All studies had to use the SDS, be double-blind, controlled or large open-label trials in English. Studies assessing nonpharmacological treatments, long-term trials (>12 weeks), small n trials (less than 20 patients per treatment arm) and trials for conditions other than one of the anxiety disorders, depression, or premenstrual dysphoric disorder were excluded. Extracted data included the diagnostic target of treatment, n, study design, and method of analysis. Initial, endpoint and/or mean change scores were extracted from tables, text, or extrapolated from figures. In all, 37 studies meeting the inclusion criteria were retrieved and reviewed. All of the studies treated the SDS as a numeric scale and analyzed mean change or endpoint differences with parametric statistics. Three provided additional outcome data using nonparametric response or remission criteria. Overall, the SDS performed well in discriminating between active and inactive treatments. The results indicate that the SDS is sensitive to treatment effects. To establish reliable and valid cutoff scores for remission and response, there is a need to supplement parametric analyses using mean change and endpoint differences with nonparametric analyses showing the percentage meeting specified response and remission criteria. In addition, the percentages with endpoint scores of zero should be reported.

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“…The most frequently prescribed pharmacologic agents for treating anxiety are benzodiazepines and selective serotonin reuptake inhibitors (SSRIs), which are effective for 40-80% of patients depending on the disorder and the specific study (Asnis et al, 2001;Bandelow et al, 2004;Davidson et al, 1993Davidson et al, , 2004Hoffman and Mathew, 2008;Jorstad-Stein and Heimberg, 2009;Kasper et al, 2005;Laakmann et al, 1998;Mitte et al, 2005;Moroz and Rosenbaum, 1999;Pull and Damsa, 2008;Stein et al, 1999;Van Ameringen et al, 2009). Clinicians are often hesitant to prescribe benzodiazepines because of concerns about long-term efficacy, side effects (including sedation and cognitive impairment), and potential risks for abuse or dependence (Cloos and Ferreira, 2009;McIntosh et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Pregabalin Influences Insula and Amygdala Activation During Anticipation of Emotional Images

Aupperle

Ravindran

Tankersley

et al. 2011

Neuropsychopharmacol

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Pregabalin (PGB) has shown potential as an anxiolytic for treatment of generalized and social anxiety disorder. PGB binds to voltagedependent calcium channels, leading to upregulation of GABA inhibitory activity and reduction in the release of various neurotransmitters. Previous functional magnetic resonance imaging (fMRI) studies indicate that selective serotonin reuptake inhibitors and benzodiazepines attenuate amygdala, insula, and medial prefrontal cortex activation during anticipation and emotional processing in healthy controls. The aim of this study was to examine whether acute PGB administration would attenuate activation in these regions during emotional anticipation. In this double-blind, placebo-controlled, randomized crossover study, 16 healthy controls completed a paradigm involving anticipation of negative and positive affective images during fMRI approximately 1 h after administration of placebo, 50, or 200 mg PGB. Linear mixed model analysis revealed that PGB was associated with (1) decreases in left amygdala and anterior insula activation and (2) increases in anterior cingulate (ACC) activation, during anticipation of positive and negative stimuli. There was also a region of the anterior amygdala in which PGB dose was associated with increased activation during anticipation of negative and decreased activation during anticipation of positive stimuli. Attenuation of amygdala and insula activation during anticipatory or emotional processing may represent a common regional brain mechanism for anxiolytics across drug classes. PGB induced increases in ACC activation could be a unique effect related to top-down modulation of affective processing. These results provide further support for the viability of using pharmaco-fMRI to determine the anxiolytic potential of pharmacologic agents.

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Fluvoxamine in the treatment of panic disorder: a multi-center, double-blind, placebo-controlled study in outpatients

Cited by 63 publications

References 44 publications

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Assessing treatment effects in clinical trials with the Discan metric of the Sheehan Disability Scale

Pregabalin Influences Insula and Amygdala Activation During Anticipation of Emotional Images

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