title: Psychopharmacotherapy of panic disorder: 8-week randomized trial with clonazepam and paroxetine.
abstract: The objective of the present randomized, open-label, naturalistic 8-week study was to compare the efficacy and safety of treatment with clonazepam (N = 63) and paroxetine (N = 57) in patients with panic disorder with or without agoraphobia. Efficacy assessment included number of panic attacks and clinician ratings of the global severity of panic disorders with the clinical global impression (CGI) improvement (CGI-I) and CGI severity (CGI-S) scales. Most patients were females (69.8 and 68.4% in the clonazepam and paroxetine groups, respectively) and age (mean ± SD) was 35.9 ± 9.6 years for the clonazepam group and 33.7 ± 8.8 years for the paroxetine group. Treatment with clonazepam versus paroxetine resulted in fewer weekly panic attacks at week 4 (0.1 vs 0.5, respectively; P < 0.01), and greater clinical improvements at week 8 (CGI-I: 1.6 vs 2.9; P = 0.04). Anxiety severity was significantly reduced with clonazepam versus paroxetine at weeks 1 and 2, with no difference in panic disorder severity. Patients treated with clonazepam had fewer adverse events than patients treated with paroxetine (73 vs 95%; P = 0.001). The most common adverse events were drowsiness/fatigue (57%), memory/concentration difficulties (24%), and sexual dysfunction (11%) in the clonazepam group and drowsiness/fatigue (81%), sexual dysfunction (70%), and nausea/vomiting (61%) in the paroxetine group. This naturalistic study confirms the efficacy and tolerability of clonazepam and paroxetine in the acute treatment of patients with panic disorder.
authors.affiliation: Laboratório de Pânico e Respiração, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, RJ, Brasil. antonionardi@terra.com.br
authors.forename: A E
authors.initials: AE
authors.lastname: Nardi
authors.forename: A M
authors.initials: AM
authors.lastname: Valença
authors.forename: R C
authors.initials: RC
authors.lastname: Freire
authors.forename: M D
authors.initials: MD
authors.lastname: Mochcovitch
authors.forename: R
authors.initials: R
authors.lastname: Amrein
authors.forename: A
authors.initials: A
authors.lastname: Sardinha
authors.forename: M N
authors.initials: MN
authors.lastname: Levitan
authors.forename: I
authors.initials: I
authors.lastname: Nascimento
authors.forename: V L
authors.initials: VL
authors.lastname: de-Melo-Neto
authors.forename: A L
authors.initials: AL
authors.lastname: King
authors.forename: A C
authors.initials: AC
authors.lastname: de O E Silva
authors.forename: A B
authors.initials: AB
authors.lastname: Veras
authors.forename: G P
authors.initials: GP
authors.lastname: Dias
authors.forename: G L
authors.initials: GL
authors.lastname: Soares-Filho
authors.forename: R T
authors.initials: RT
authors.lastname: da Costa
authors.forename: M A
authors.initials: MA
authors.lastname: Mezzasalma
authors.forename: M R
authors.initials: MR
authors.lastname: de Carvalho
authors.forename: A C
authors.initials: AC
authors.lastname: de Cerqueira
authors.forename: J E
authors.initials: JE
authors.lastname: Hallak
authors.forename: J A
authors.initials: JA
authors.lastname: Crippa
authors.forename: M
authors.initials: M
authors.lastname: Versiani
mesh_terms: D000293:Adolescent; D000328:Adult; D000379:Agoraphobia / Q000188:drug therapy*; D002998:Clonazepam / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000188:drug therapy*; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017374:Paroxetine; D002998:Clonazepam