The sequence of improvement of the symptoms encountered in patients with panic disorder

Deltito, Joseph; Argyle, Nick; Buller, R.; Nutzinger, Detlev O.; Ottosson, Jan-Otto; Brandon, Sydney; Mellergård, M.; Shera, David

doi:10.1016/0010-440x(91)90003-u

Cited by 15 publications

(6 citation statements)

References 7 publications

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“…As the benefit of imipramine treatment in panic disorder has been claimed to be secondary to its antidepressant efficacy (Marks 1983), Deltito et al (1991 analysed a subgroup of patients (N=312) from the CNCPS having no current or previous affective symptoms, including dysphoria. They found that the clinical response to alprazolam or imipramine was independent of the presence of current or past affective symptoms.…”

Section: Depressionmentioning

confidence: 99%

Drug Treatment of Panic Disorder

Rosenberg

1993

Pharmacology & Toxicology

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Drug treatment of panic disorder is reviewed with focus on recent controlled studies. The efficacy of alprazolam, a triazolobenzodiazepine, and imipramine, a tricyclic antidepressant, has consistently been demonstrated, but there is reasonable evidence that other benzodiazepines or antidepressants might also be effective if equipotent doses are used. Most controlled studies demonstrate drug efficacy on several psychopathological symptoms, including the core symptom panic attacks. Limited evidence indicates that alprazolam may be more efficacious in treating panic attacks than avoidance behaviour, and the reverse when imipramine is concerned. Drug efficacy appears to be most consistently documented in moderately to severely ill panic patients. The benzodiazepines are better tolerated than antidepressants in terms of patient acceptance, and the improvement sets in faster with benzodiazepines. In the presence of depressive symptoms considered secondary to panic attacks and/or agoraphobia, both types of drugs appear efficacious. Difficulty discontinuing high-dose benzodiazepine treatment remains the most important side effect of the treatment but sedation can, like anticholinergic side effects of the tricyclic antidepressants, be troublesome, thereby diminishing patient compliance. The role of newly developed antidepressants with a more specific mode of action and milder side effects awaits evaluation in controlled trials.

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Section: Depressionmentioning

confidence: 99%

Drug Treatment of Panic Disorder

Rosenberg

1993

Pharmacology & Toxicology

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“…Several studies have addressed the issue of the sequence of improvement of symptoms in patients with panic disorder upon behavioral [98, 99]or pharmacological [100, 101, 102]treatment. In one study [98], the rollback phenomenon was specifically investigated.…”

Section: Subclinical Symptoms Of Panic Disordermentioning

confidence: 99%

Subclinical Symptoms of Panic Disorder: New Insights into Pathophysiology and Treatment

Fava

Mangelli²

1999

Psychother Psychosom

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The aim of this review was to survey the available literature on prodromal and residual symptoms of panic disorder. Both a computerized (Medline) and a manual search of the literature were performed. In a substantial proportion of patients with panic disorder with agoraphobia a prodromal phase can be identified. Most patients report residual symptoms despite successful treatment. Residual symptoms upon remission have a prognostic value. There appears to be a relationship between residual and prodromal symptomatology (the rollback phenomenon). Appraisal of subclinical symptomatology in panic disorder has important implications as to the pathophysiological model of disease, its conceptualization and treatment.

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“…The many previous studies of symptomatology include some in which the individual symptoms were examined; these featured investigation of the sequence of panic symptoms (10)(11)(12), the existence of symptoms of fearfulness (13,14), and the pro-dromal symptoms (15,16). Little has been done, however, to describe the phenomenon itself using statistical procedures (17)(18)(19).…”

mentioning

confidence: 99%

The symptom structure of panic disorder: a trial using factor and cluster analysis

Shioiri

Someya

Murashita

et al. 1996

Acta Psychiatr Scand

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Using cluster analysis of 207 patients with panic disorder (PD), we investigated the relationships between several panic symptoms at the time of panic attacks, which included anticipatory anxiety, agoraphobia, and 13 clinical symptoms based on the Diagnostic and Statistics Manual-III-Revised. Cluster analysis revealed three panic symptom clusters: cluster A (dyspnea, choking, sweating, nausea, flushes/chills); cluster B (dizziness, palpitations, trembling or shaking, depersonalization, agoraphobia, and anticipatory anxiety); and cluster C (fear of dying, fear of going crazy, paresthesias, and chest pain or discomfort). Generally, cluster A was comprised exclusively of physiological symptoms, among which respiratory symptoms were prominent, cluster B included both panic and non-panic symptoms such as agoraphobia and anticipatory anxiety, and cluster C was comprised chiefly of fear symptoms.

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The sequence of improvement of the symptoms encountered in patients with panic disorder

Cited by 15 publications

References 7 publications

Drug Treatment of Panic Disorder

Drug Treatment of Panic Disorder

Subclinical Symptoms of Panic Disorder: New Insights into Pathophysiology and Treatment

The symptom structure of panic disorder: a trial using factor and cluster analysis

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