title: Simultaneous major depression and panic disorder: treatment with electroconvulsive therapy.
abstract: BACKGROUND
  Major depression and panic disorder commonly occur together. Patients with simultaneous depression and panic disorder may have a higher lifetime rate of suicide attempts and an overall worse prognosis than patients with either depression or panic disorder alone. In addition, preliminary work suggests that some of these patients may not respond satisfactorily to antidepressants. In this report, we describe the clinical courses of eight consecutive patients with simultaneous major depression and panic disorder who were referred for ECT at our institution.
  
  
  METHODS
  Eight consecutive patients who met DSM-III-R criteria for simultaneous major depression and panic disorder received ECT. All eight patients were evaluated by a structured clinical interview and the patients' major depression and panic disorder were evaluated with a 7-point Clinical Global Impressions severity rating scale.
  
  
  RESULTS
  Before ECT was begun, each subject's panic disorder and depression were rated as at least markedly ill. After receiving ECT, all eight showed improvement in their depression. In addition, none of the eight patients reported having a panic attack from the time of their fourth ECT treatment until discharge.
  
  
  CONCLUSIONS
  In this report, eight consecutive patients with simultaneous major depression and panic disorder improved with ECT. Further work is required which examines the potential utility of ECT in treating these patients.
authors.affiliation: Washington University School of Medicine, Department of Psychiatry, St. Louis 63110.
authors.forename: G S
authors.initials: GS
authors.lastname: Figiel
authors.forename: C F
authors.initials: CF
authors.lastname: Zorumski
authors.forename: P M
authors.initials: PM
authors.lastname: Doraiswamy
authors.forename: G W
authors.initials: GW
authors.lastname: Mattingly
authors.forename: M R
authors.initials: MR
authors.lastname: Jarvis
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016896:Treatment Outcome