A three-year follow-up study of patients with the respiratory subtype of panic disorder after treatment with clonazepam

Psychopharmacotherapy of panic disorder: 8-week randomized trial with clonazepam and paroxetine

“…The present investigation confirms earlier studies, which have demonstrated the efficacy of clonazepam (11,12,21,(28)(29)(30) and paroxetine (18,19,31,32) in separate trials in the treatment of panic disorder. The present study compares clonazepam with paroxetine using a parallel methodology with the same team of health providers.…”

“…remain symptomatic and this proportion may be higher in the naturalistic setting (9). In addition, the subtype of panic disorder (respiratory or non-respiratory) can influence the response to pharmacotherapy and affect outcomes (10)(11)(12). Furthermore, discontinuation of pharmacotherapy can lead to withdrawal symptoms and a significant number of panic disorder patients suffer relapse flowing cessation of treatment (13,14).…”

“…Benzodiazepines are rapidly acting, effective, well tolerated and suitable as monotherapy (11,21) or combination therapy (22). Clonazepam also affects serotonin transmission (23,24) and is the only benzodiazepine on the market for which additional serotonergic activity has been shown, an action that may contribute to its ansiolytic effects (23)(24)(25).…”

Are patients with panic disorder respiratory subtype more vulnerable to tobacco, alcohol or illicit drug use?

“…The authors also found higher comorbidity with agoraphobia, social anxiety disorder, generalized anxiety disorder and specific phobia for the respiratory subtype, compared to the non-respiratory subtype 10 . In two studies with smaller samples 11,12 the respiratory subtype was associated with low comorbidity with major depressive disorder, but in the study of Roberson-Nay et al 10 the opposite was found. There were also conflicting findings regarding the duration of the illness 5,10 .…”

The carbon dioxide challenge test in panic disorder: a systematic review of preclinical and clinical research

“…This classification has had a great impact on patient psychopathology, response to treatment and prognosis. 6 New hypotheses for PD have advanced enormously in the last decades due to the possibility of reproducing PAs in a safe and controlled environment. The carbon dioxide (CO 2 ) challenge has been regarded as a safe and noninvasive method to provoke PAs in PD patients in preclinical and clinical research settings, and has enabled investigators to: analyze sensitivity to hypercapnia in PD, assessing the validity of Klein's suffocation alarm theory; discriminate the respiratory (R-PD) and non-respiratory (nR-PD) subtypes of PD according to patient sensitivity to hypercapnia; test the sensitivity of healthy relatives of PD patients to the CO 2 challenge; verify the ability of drugs with known pharmacokinetics to prevent, eliminate, or reduce CO 2 sensitivity in R-PDs, shedding light on the neural mechanisms of PAs and potential treatment options for PD; assess the efficacy of non-drug treatments, such as physical exercise, in preventing PAs caused by hypercapnia; and develop genetic screening for CO 2 -sensitive PD.…”