title: Adverse effects associated with the short-term treatment of panic disorder with imipramine, alprazolam or placebo.
abstract: 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. If a 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.
authors.affiliation: Psychiatric Clinic II, University of Pisa, Italy.
authors.forename: G B
authors.initials: GB
authors.lastname: Cassano
authors.forename: C
authors.initials: C
authors.lastname: Toni
authors.forename: A
authors.initials: A
authors.lastname: Petracca
authors.forename: J
authors.initials: J
authors.lastname: Deltito
authors.forename: O
authors.initials: O
authors.lastname: Benkert
authors.forename: G
authors.initials: G
authors.lastname: Curtis
authors.forename: H
authors.initials: H
authors.lastname: Hippius
authors.forename: W
authors.initials: W
authors.lastname: Maier
authors.forename: D
authors.initials: D
authors.lastname: Shera
authors.forename: G
authors.initials: G
authors.lastname: Klerman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000525:Alprazolam / Q000009:adverse effects* / Q000627:therapeutic use; D004311:Double-Blind Method; D006801:Humans; D007099:Imipramine / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D016584:Panic Disorder / Q000188:drug therapy / Q000523:psychology*; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales
chemical_list: D007099:Imipramine; D000525:Alprazolam