title: Open-label support for duloxetine for the treatment of panic disorder.
abstract: Panic disorder with or without agoraphobia is a common, often chronic and refractory anxiety disorder. Although a number of pharmacotherapies are now indicated for panic disorder, many patients do not respond to available interventions. We hypothesized that duloxetine, a serotonin-norepinephrine reuptake inhibitor (SNRI) that has greater initial noradrenergic effects than venlafaxine, would have broad efficacy for individuals with panic disorder. Fifteen individuals with panic disorder with or without agoraphobia received 8 weeks of open label duloxetine flexibly dosed from 60 to 120 mg per day. Duloxetine treatment resulted in significant anxiolysis as measured by the primary outcome measure, the Panic Disorder Severity Scale (PDSS) (paired t(df) = 4.02(14), P= 0.0013), as well as measures of generalized anxiety, depression and quality of life (all P < 0.05). Although definitive conclusions are limited due to its small open-label nature, this first prospective study provides preliminary support for the efficacy of duloxetine for panic disorder and suggests larger randomized controlled study is warranted.
authors.affiliation: Department of Psychiatry, Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA. nsimon@partners.org
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Simon
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Kaufman
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hoge
authors.forename: John J
authors.initials: JJ
authors.lastname: Worthington
authors.forename: Nannette N
authors.initials: NN
authors.lastname: Herlands
authors.forename: Maryann E
authors.initials: ME
authors.lastname: Owens
authors.forename: Mark H
authors.initials: MH
authors.lastname: Pollack
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000068736:Duloxetine Hydrochloride; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000068736:Duloxetine Hydrochloride; D017367:Selective Serotonin Reuptake Inhibitors; D013876:Thiophenes