Double-blind clonazepam vs placebo in panic disorder treatment

Abstract

-Objective: To assess the effectiveness of clonazepam, in a fixed dose (2 mg/day), compared with placebo in the treatment of panic disorder patients. Method: 24 panic disorder patients with agoraphobia were randomly selected. The diagnosis was obtained using the structured clinical interview for DSM-IV . All twentyfour subjects were randomly assigned to either treatment with clonazepam (2 mg/day) or placebo, during 6 weeks. Efficacy assessments included: change from baseline in the number of panic attacks; CGI scores for panic disorder; Hamilton rating scale for anxiety; and panic associated symptoms scale. Results: At the therapeutic endpoint, only one of 9 placebo patients (11.1%) were free of panic attacks, compared with 8 of 13 (61.5%) clonazepam patients (Fisher exact test; p=0,031). Conclusion : the results provide evidence for the efficacy of clonazepam in panic disorder patients.KEY WORDS: panic disorder, panic attack, clonazepam, treatment. Estudo duplo-cego com clonazepam e placebo no tratamento do transtorno do pânicoRESUMO -Objetivo: Avaliar a eficácia do clonazepam, em uma dose fixa (2 mg/dia), comparado ao placebo, no tratamento de pacientes com transtorno do pânico. Método: Foram selecionados randomicamente 24 pacientes com transtorno do pânico com agorafobia. O diagnóstico foi obtido através da entrevista clínica estruturada do DSM-IV. Todos os 24 pacientes foram randomicamente designados para tratamento com clonazepam (2 mg/dia) ou placebo, durante 6 semanas. Para avaliação da eficácia foram utilizadas: mudança do número de ataques de pânico em relação ao período anterior ao tratamento; escala de Hamilton de ansiedade; escala de sintomas associados ao transtorno do pânico. Resultados: No final da sexta semana, apenas um de 9 dos pacientes que receberam placebo(11,1%) ficaram livres de ataques de pânico, comparados a 8 de 13 (61,5%) pacientes que receberam clonazepam (prova exata de Fisher; p=0,031). Conclusão: Os resultados evidenciam a eficácia do clonazepam no tratamento de pacientes com transtorno do pânico. PALAVRAS-CHAVE: transtorno do pânico, ataque de pânico, clonazepam, tratamento.Panic disorder is a common psychiatric illness that can have a chronic course 1 . The symptoms include recurrent panic attacks and persistent concern about having another attack or worry about the implications and consequences of the attack 1 . Epidemiologic data have documented a lifetime prevalence of 1.6% -2.2%, age at first onset in the age of 20s and higher risk in females (about twofold) 2 . Prompt recognition and treatment of panic attacks is important because quality of life is typically poor, chronic illness can develop and sufferers are at particular risk of developing other psychiatric conditions, such as agoraphobia, anxiety and depression 3 . Medications from several classes have been shown to be effective in panic disorder treatment: selective serotonin reuptake

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.…”

“…The AEs reported for clonazepam are typical of those expected from a highly potent benzodiazepine, and consistent with the safety profile of clonazepam observed in other studies (11,22,30). The most frequently reported AEs were drowsiness and lapse in memory/concentration.…”

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.…”

“…The AEs reported for clonazepam are typical of those expected from a highly potent benzodiazepine, and consistent with the safety profile of clonazepam observed in other studies (11,22,30). The most frequently reported AEs were drowsiness and lapse in memory/concentration.…”

Clonidine in respiratory panic disorder subtype

“…Modalities for which there is considerable evidence of efficacy in the treatment of PD include cognitive behavioral therapies 3 and pharmacotherapy. Medications from several classes have been shown to be effective in PD treatment: selective serotonin reuptake inhibitors -SSRI 4 , tricyclic antidepressants 5 high-potency benzodiazepines 6,7 and monoamine-oxidase inhibitors -MAO-I 8 . It has been hypothesized that the alpha 2 -adrenergic receptor agonist clonidine also may be useful in the treatment of PD 9,10 .…”