Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-27T23:53:10.570Z Has data issue: false hasContentIssue false

Continuing treatment of panic disorder after acute response: randomised, placebo-controlled trial with fluoxetine

Published online by Cambridge University Press:  02 January 2018

David Michelson*
Affiliation:
Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
Mark Pollack
Affiliation:
Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
R. Bruce Lydiard
Affiliation:
Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
Roy Tamura
Affiliation:
Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
Rosalinda Tepner
Affiliation:
Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
Gary Tollefson
Affiliation:
Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
*
Dr David Michelson, Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Drop Code 2324, Indianapolis, IN 46285, USA. Tel: (317) 277-6443; Fax: (317) 277-3262

Abstract

Background

Data concerning appropriate treatment in panic disorder following an initial response to acute therapy are limited.

Aims

To assess the safety and efficacy of continued fluoxetine treatment following successful acute therapy of panic disorder.

Method

Patients who responded to acute fluoxetine treatment were randomised to 24 weeks of continued fluoxetine or placebo.

Results

Fluoxetine responders randomised to continue on their acute-phase fluoxetine dose experienced statistically significant improvement in panic attack frequency and phobia rating scale score over 24 weeks of therapy, while those switched to placebo experienced statistically significant worsening in Hamilton Anxiety (HAM–A), Hamilton Depression (HAM–D) and SCL–90–R rating scores.

Conclusions

Fluoxetine was associated with improved clinical outcomes compared with placebo during continuation therapy.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Declaration of interest

This study was funded by Eli Lilly and Company. Dr Michelson, Dr Tamura, Dr Tollefson and MsTepner are employees of Eli Lilly and Company. Dr Pollack and Dr Lydiard are paid consultants to Eli Lilly and Company.

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: American Psychiatric Association.Google Scholar
Aronson, T. A. (1987) A naturalistic study of imipramine in panic disorder and agoraphobia. American Journal of Psychiatry, 144, 10141019.Google Scholar
Burrows, G. D., Judo, F. K. & Norman, T. R. (1993) Long-term drug treatment of panic disorder. Journal of Psychiatric Research, 27 (suppl. 1), 111125.CrossRefGoogle ScholarPubMed
Curtis, G. C., Massan, J., Udina, D., et al (1993) Maintenance drug therapy of panic disorder. Journal of Psychiatric Research, 27 (suppl. 1), 127142.Google Scholar
Derogatis, L., Rickels, K., Uhlenhuth, E. H., et al (1974) The Hopkins Symptom Checklist: A measure of primary symptom dimensions. In Psychological Measurements in Psychopharmacology: Problems in Psychopharmacology. pp. 79110. Basel: Karger.Google Scholar
Guy, W. (1974) ECDEU Assessment Manual for Psychopharmacology, pp. 218222. Washington, DC: US Department of Health, Education and Welfare.Google Scholar
Hamilton, M. (1987) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278296.Google Scholar
Hamilton, M. (1969) Diagnosis and rating of anxiety. British Journal of Psychiatry, 113, 7679.Google Scholar
Judge, R., Burnham, D. B., Steiner, M. X., et al (1996) Paroxetine long-term safety and efficacy in panic disorder and prevention of relapse: a double-blind study. In Xth World Congress of Psychiatry, Madrid, Vol. 2. New York: World Psychiatric Association.Google Scholar
Lecrubier, Y. & Judge, R. (1997) Long-term evaluation of paroxetine, clomipramine and placebo in panic disorder. Collaborative Paroxetine Panic Study Investigators. Acta Psychiatrica Scandinavica, 95, 153160.Google Scholar
Michelson, D., Lydiard, R. B., Pollack, M., et al (1998) Outcome assessment and clinical improvement in panic disorder: evidence from a randomized controlled trial of fluoxetine and placebo. American Journal of Psychiatry, 155, 15701577.Google Scholar
Nagy, L. M., Krystal, J. H., Woods, S. W. et al (1989) Clinical and medication outcome after short-term alprazolam and behavioral group treatment in panic disorder. 2.5 year naturalistic follow-up study. Archives of General Psychiatry, 46, 993999.Google Scholar
Nagy, L. M., Krystal, J. H., Charney, D. S., et al (1993) Long-term outcome of panic disorder after short-term imipramine and behavioral group treatment: 2.9-year naturalistic follow-up study. Journal of Clinical Psychopharmacology, 13, 1624.Google Scholar
Noyes, R. Jr., Garvey, M. J., Cook, B. L., et al (1989) Problems with tricyclic antidepressant use in patients with panic disorder or agoraphobia: results of a naturalistic follow-up study. Journal of Clinical Psychiatry, 50, 163169.Google Scholar
Pollack, M. H., Tesar, G. E., Rosenbaum, J. F., et al (1988) Clonazepam in the treatment of panic disorder and agoraphobia: a one-year follow-up. Journal of Clinical Psychopharmacology, 6, 302304.Google Scholar
Pollack, M. H. & Smoller, J. W. (1995) The longitudinal course and outcome of panic disorder [Review]. Psychiatric Clinics of North America, 18, 785801.CrossRefGoogle ScholarPubMed
Price, J. S., Waller, P. C., Wood, S. M. et al (1996) A comparison of the post-marketing safety of four selective serotonin re-uptake inhibitors including the investigation of symptoms occurring on withdrawal. British Journal of Clinical Pharmacology, 42, 757763.Google Scholar
Pyloe, R. E. (1995) Paroxetine withdrawal syndrome [Letter]. American Journal of Psychiatry, 152, 149150.Google Scholar
Rosenbaum, J. F., Fava, M., Hoog, S. L., et al (1998) Selective serotonin reuptake inhibitor discontinuation syndrome: a randomized clinical trial. Biological Psychiatry, 44, 7787.CrossRefGoogle ScholarPubMed
Shear, M. K. & Maser, J. D. (1994) Standardized assessment for panic disorder research. A conference report. Archives of General Psychiatry, 51, 346354.Google Scholar
Sneehan, D. V. (1983) The Anxiety Disease. New York: Charles Scribner and Sons.Google Scholar
Spitzer, R. L., Williams, J. B. W. & Gibbons, M. (1986) The Structured Clinical Interview for DSM–III–R (SOD). New York: New York State Psychiatric Institute.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.