Abstract

toms, they do not consider that carbamazepine may have inherent antipanic properties and may act to suppress reemergent panic symptoms rather than alleviate the symptoms of alprazolam withdrawal. Tricyclic antidepressants, notably imipramine, have antipanic activity (1). The antidepressant effect of carbamazepine (2) may be related to its tricyclic nucleus, and this same structural feature could, theoretically, confer antipanic activity on this drug.REFERENCES 1. Zitrin CM, Klein DF, Woerner MG, et al: Treatment of phobias: comparison of imipramine hydrochloride and placebo. Arch Gen Psychiatry 1983; 40:125-138 2. Post RM, Uhde TW, Roy-Byrne PP, et al: Antidepressant effects of carbamazepine. Am J Psychiatry 1986; 143:29-34 BRIAN A. LAWLOR,Gainesville,to have mild to moderate antianxiety properties in some patients (3, 4), carbamazepine’s most noteworthy effects in panic patients in our clinic have been the reduction of help-seeking behavior and dysphoria rather than blockade of panic attacks. Of interest, we found carbamazepine effective as an antipanic agent in the treatment of a patient with cocaine-induced panic attacks who later developed spontaneous panic attacks unrelated to cocaine use (5). As we noted in the original article, carbamazepine itself does not act at the central benzodiazepine receptor site and is not associated with tolerance or