The efficacy of reboxetine in the treatment-refractory patients with panic disorder: an open label study.
OBJECTIVE
Selective serotonin reuptake inhibitors (SSRIs) are currently the first-line treatment for panic disorder, although up to 30% of patients either do not respond to SSRIs or withdraw due to adverse events. Reboxetine, a selective norepinephrine reuptake inhibitor (selective NRI), is effective in treating depression and may alleviate depression-related anxiety. This study aimed to investigate the efficacy of reboxetine in the treatment of patients with panic disorder who did not respond to SSRIs.


METHODS
In this 6-week, open-label study, 29 adult outpatients with panic disorder who had previously failed to respond to SSRI treatment received reboxetine 2 mg/day, titrated to a maximum of 8 mg/day over the first 10 days. Efficacy was assessed using the Panic Self-Questionnaire (PSQ), the Hamilton Rating Scale for Anxiety (HAM-A), the 17-item Hamilton Rating Scale for Depression (HRSD) and the Global Assessment of Functioning (GAF) Scale.


RESULTS
The 24 patients who completed the study responded well to reboxetine treatment. Significant improvement (p < 0.001) was observed in the number of daily panic attacks, and on the scales measuring anxiety, depression and functioning. Reboxetine was generally well tolerated. Five patients withdrew due to adverse events.


CONCLUSIONS
Reboxetine appears to be effective in the treatment of SSRI-refractory panic disorder patients and warrants further clinical investigation.
Dannon
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Chaim Sheba Medical Center, Psychiatry Division, Tel Hashomer, Affiliated with the Sackler School of Medicine, Tel Aviv University, Israel. dannon@attglobal.net
Iancu
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Grunhaus
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D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000379:Agoraphobia / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D009025:Morpholines / Q000009:adverse effects / Q000627:therapeutic use*; D016584:Panic Disorder / Q000188:drug therapy* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D000077593:Reboxetine; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D009025:Morpholines; D000077593:Reboxetine; D017367:Selective Serotonin Reuptake Inhibitors