Olanzapine augmentation in treatment-resistant panic disorder: a 12-week, fixed-dose, open-label trial.
The purpose of our study was to evaluate the efficacy and tolerability of low-dose olanzapine augmentation in selective serotonin reuptake inhibitor (SSRI)-resistant panic disorder (PD) with or without agoraphobia. In this 12-week, open-label study, 31 adult outpatients with treatment-resistant PD who had previously failed to respond to SSRI treatment were treated with fixed dose of olanzapine (5 mg/d) in addition to SSRI. Efficacy was assessed using the Panic Attack and Anticipatory Anxiety Scale (PAAAS), the Agoraphobic Cognitions Questionnaire (ACQ), the Hamilton Rating Scale for Anxiety (HAM-A), the Hamilton Rating Scale for Depression (HAM-D), the Global Assessment of Functioning Scale (GAF), and the Clinical Global Impression of Improvement (CGI-I). Twenty-six patients completed the trial period with a dropout rate of 16.1%. At week 12, 21 patients were responders (81.8%), and an overall improvement on all rating scales was observed in all patients both with or without agoraphobia. Fifteen patients (57.7%) achieved remission. Olanzapine was well tolerated and the most frequent adverse effects were mild-to-moderate weight gain and drowsiness. No extrapyramidal symptoms were reported. Olanzapine appears to be effective as augmentation strategy in the treatment of SSRI-resistant PD, but study limitations must be considered and placebo-controlled studies are needed.
Sepede
Gianna
G
Department of Oncology and Neurosciences, Institute of Psychiatry, University G. D Annunzio of Chieti, Italy.
De Berardis
Domenico
D
Gambi
Francesco
F
Campanella
Daniela
D
La Rovere
Raffaella
R
D'Amico
Michele
M
Cicconetti
Alessandra
A
Penna
Laura
L
Peca
Silvana
S
Carano
Alessandro
A
Mancini
Enrico
E
Salerno
Rosa Maria
RM
Ferro
Filippo Maria
FM
D000328:Adult; D000379:Agoraphobia / Q000150:complications / Q000188:drug therapy; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D000077152:Olanzapine; D016584:Panic Disorder / Q000150:complications / Q000188:drug therapy*; D017374:Paroxetine / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D020280:Sertraline / Q000627:therapeutic use; D017211:Treatment Failure
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline