6533b832fe1ef96bd129acf3

RESEARCH PRODUCT

Adverse effects associated with the short-term treatment of panic disorder with imipramine, alprazolam or placebo

George C. CurtisGerald L. KlermanCristina ToniOtto BenkertJoseph DeltitoWolfgang MaierHanns HippiusDavid SheraGiovanni B. CassanoA Petracca

subject

AdultImipramineAdolescentSide effectPoison controlPlaceboImipramineDouble-Blind MethodmedicineHumansPharmacology (medical)Biological PsychiatryAgedPsychiatric Status Rating ScalesPharmacologyAlprazolambusiness.industryPanic disorderPanicMiddle Agedmedicine.diseasePsychiatry and Mental healthNeurologyAlprazolamAnesthesiaPanic DisorderPatient ComplianceNeurology (clinical)medicine.symptombusinessAgoraphobiamedicine.drug

description

Summary Side effects play a significant role in the selection of drugs to be used in panic disorder/agoraphobia whose polyphobic symptomatology often includes a suspiciousness about taking drugs and a fear of undesired side effects which may lead to the refusal of treatment. The safety, side effects and patients' acceptance of alprazolam and imipramine versus placebo were evaluated in 1168 subjects with panic disorder/agoraphobia who had been enrolled in the second phase of the Upjohn World Wide Panic Study. Side effects that worsened over baseline to a greater extent with alprazolam than with imipramine and placebo were sedation, fatigue/weakness, memory problems, ataxia and slurred speech. In the imipramine group blurred vision, tachycardia/palpitations, insomnia, sleep disturbance, excitement/nervousness, malaise, dizziness/faintness, headache, nausea/vomiting and decrease in appetite were worse than in the other groups. In the placebo group the anxious symptoms were most prominent. The highest level of compliance was shown in the alprazolam-treated group and the lowest in the placebo-treated group. Strong predictors of side effects were not observed. lfa side effect profile is known, it will be easier for a clinician to choose the right drug and the appropriate management by taking into account compliance, safety and efficacy in each patient under treatment. Further information about side effects in long-term maintenance treatment would be of great clinical pertinence in ensuring safety and enhancing patients' quality of life.

https://doi.org/10.1016/0924-977x(94)90314-x