Treatment of panic disorder in older adults: a pilot study comparison of alprazolam, imipramine, and placebo.
OBJECTIVE
Several studies have documented that a variety of pharmacological compounds are quite effective in controlling acute symptomatology of panic disorder in the general population. However, there is a paucity of such studies in the management of panic disorder in older adults (ages 55 and above). The purpose of this study was to gather pilot data in older patients with panic disorder to begin to assess the efficacy of two commonly-used antipanic medications, imipramine and alprazolam.


METHODS
Twenty-five (n = 25 (23 females; 2 males); 18 completers, 7 dropouts) older panic disorder (DSM-III-R) patients (age range = 55-73; mean = 61.24) were studied in an eight-week randomized, parallel-groups, double-blind, placebo-controlled, flexible dose design. Outcome was assessed weekly by global change ratings (Hamilton Anxiety and Depression Scales; Physicians' Global Impression ratings) and panic diaries. Because of small sample size, we present data descriptively.


RESULTS
Subjects in active medication groups evidenced reductions in panic attacks and in level of overall anxiety and depression. Therapeutic dosages were approximately half those commonly used in younger panic disorder patients.


CONCLUSIONS
Our data suggest the comparable efficacy of alprazolam and imipramine in the short-term treatment of older adults with panic disorder. There is clearly the need for a larger scale placebo-controlled study, preferably comparing imipramine and/or alprazolam with one of the SSRIs, to substantiate our findings.
Sheikh
J I
JI
Stanford University School of Medicine, California, USA.
Swales
P J
PJ
D000368:Aged; D000525:Alprazolam / Q000627:therapeutic use*; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000188:drug therapy*; D010865:Pilot Projects
D014151:Anti-Anxiety Agents; D000929:Antidepressive Agents, Tricyclic; D007099:Imipramine; D000525:Alprazolam