title: Memory performance in panic disorder patients after chronic use of clomipramine.
abstract: This study investigated the chronic use (6.3 +/- 0.5 years; mean +/- SEM) of therapeutic doses of clomipramine (57.0 +/- 8.0 mg/day) by outpatients with panic disorder/agoraphobia who were currently in remission to assess impairment of memory and psychomotor functions. In addition, the association between test performance and serum levels of clomipramine (CMI) and its active metabolite desmethylclomipramine (DCMI) was also assessed. Patients and healthy volunteers matched for sex, age and educational level were submitted to rating scales and to memory and psychomotor tests. There was no significant difference between groups regarding any variable, except for metamemory. Significant associations were found between (i) longer-term clomipramine treatment and poorer performance in the implicit test and (ii) higher serum levels of clomipramine or desmethylclomipramine, or both (CMI + DCMI) and lower performance in central executive tests and metamemory. The results showed that low doses of CMI chronically administered to panic patients are associated with diminished metamemory and impaired priming and working memory. Further investigations are needed to confirm these results and to determine whether the chronic use of higher therapeutic doses of tricyclic antidepressants is associated with more intense deleterious effects on memory and psychomotor functions.
authors.affiliation: Departamento de Farmacologia, Instituto de Ciências Biomédicas, Faculdade de Medicina, Universidade de São Paulo, Brazil.
authors.forename: Stefania Caldeira
authors.initials: SC
authors.lastname: de Carvalho
authors.forename: Tania
authors.initials: T
authors.lastname: Marcourakis
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Artes
authors.forename: Clarice
authors.initials: C
authors.lastname: Gorenstein
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D002908:Chronic Disease; D002997:Clomipramine / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D011939:Mental Recall / Q000187:drug effects*; D008875:Middle Aged; D009483:Neuropsychological Tests; D016584:Panic Disorder / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D011597:Psychomotor Performance / Q000187:drug effects*; D012016:Reference Values
chemical_list: D000929:Antidepressive Agents, Tricyclic; D002997:Clomipramine