Citalopram controls phobic symptoms in patients with panic disorder: randomized controlled trial.
OBJECTIVE
To examine the effects of long-term treatment with citalopram or clomipramine on subjective phobic symptoms in patients with panic disorder.


METHODS
Double-blind, parallel-group, five-arm study.


METHODS
Patients aged 18 to 65 years with panic disorder (DMS-III-R diagnosis) and with no major depressive symptoms.


METHODS
Four hundred and seventy-five patients were randomized to 8 weeks of treatment with either citalopram (10 to 15 mg per day; 20 to 30 mg per day; or 40 to 60 mg per day), clomipramine (60 to 90 mg per day) or placebo. Two hundred and seventy-nine patients continued treatment after the 8-week acute phase.


METHODS
Phobic symptoms were assessed using the Phobia Scale and the Symptom Checklist's (SCL-90) phobia-related factors.


RESULTS
At all dosages, citalopram was more efficacious than placebo, with 20 to 30 mg generally being the most effective dosage. Citalopram (20 to 30 mg) generally decreased phobic symptoms significantly more than placebo after Month 3. Interpersonal sensitivity decreased when measured on the respective SCL-90 sub-scale. Alleviation of phobic symptoms generally continued to increase towards the end of the treatment. The effect of clomipramine was not as consistent.


CONCLUSIONS
All active treatment groups, especially the group receiving 20 to 30 mg per day of citalopram, effectively controlled phobic symptoms in patients with panic disorder. Long-term treatment with citalopram further decreased phobic symptoms.
Leinonen
E
E
Department of Psychogeriatrics, Tampere University Hospital, Finland. esa.leinonen@tays.fi
Lepola
U
U
Koponen
H
H
Turtonen
J
J
Wade
A
A
Lehto
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D015283:Citalopram / Q000008:administration & dosage* / Q000009:adverse effects; D002997:Clomipramine / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D010698:Phobic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D015283:Citalopram; D002997:Clomipramine; D017367:Selective Serotonin Reuptake Inhibitors