title: Prevalence and management of panic attacks during infliximab infusion in psoriatic patients.
abstract: BACKGROUND
  Psoriasis is a chronic, inflammatory skin disease associated with anxiety and depression. Infliximab (IFX) is a human/mouse chimeric anti-TNF-α antibody effective in the treatment of psoriasis.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the prevalence of panic disorders in psoriatic patients during IFX infusions.
  
  
  METHODS
  A retrospective study was performed on patients affected with psoriasis who were treated with IFX from 2002 to 2011 at a single center. Panic disorders were defined using the clinical criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. A population of dermatological patients under treatment with IVG, rituximab, apheresis, intravenous corticosteroids and antibiotics was considered as the control group.
  
  
  RESULTS
  A total of 141 patients were evaluated. Of these, 6 (4.25%) experienced panic attacks during the infusion; 16 (11.3%) had a medical history of panic attack and of those 5/16 (31%) experienced panic attacks during IFX infusion. In the control group panic attacks were not recorded.
  
  
  CONCLUSIONS
  We describe 6 cases of patients in whom panic attacks were triggered by IFX infusion. Premedication with oral benzodiazepine and a slow rate of infusion is recommended.
authors.affiliation: Department of Dermatology, University of Rome Tor Vergata, Rome, Italy. rositasaraceno@yahoo.it
authors.forename: R
authors.initials: R
authors.lastname: Saraceno
authors.forename: S
authors.initials: S
authors.lastname: Faleri
authors.forename: M
authors.initials: M
authors.lastname: Ruzzetti
authors.forename: D
authors.initials: D
authors.lastname: Centonze
authors.forename: S
authors.initials: S
authors.lastname: Chimenti
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D001569:Benzodiazepines / Q000627:therapeutic use; D016022:Case-Control Studies; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000139:chemically induced* / Q000188:drug therapy; D015995:Prevalence; D011565:Psoriasis / Q000188:drug therapy*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies
chemical_list: D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D001569:Benzodiazepines; D000069285:Infliximab