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Imiprmaine vs. Sertraline in Panic Disorder: 24-Week Treatment Completers

Imiprmaine vs. Sertraline in Panic Disorder: 24-Week Treatment Completers Despite the acknowledged favorable side effects profile of selective serotonin reuptake inhibitors (SSRIs), comparative studies have not found significant differences in efficacy between tricyclics (TCAs) such as imipramine and clomipramine, and SSRIs in the treatment of panic disorder. The present study focuses on treatment completers to inform patients who adhere to a recommended course of treatment on the possible differential patterns of improvement and of change in side effects between sertraline and imipramine. From an intent to treat consecutive sample of patients participating in the 24-week open phase protocolized treatment of a long-term controlled maintenance/discontinuation study, 20 imipramine completers and 16 sertraline completers with moderate to severe baseline symptomatology were compared using primarily repeated measures analysis of variance on measures of symptom severity, on 15 side effects systematically elicited using an inventory and on heart rate and weight. The results revealed greater early improvement with imipramine compared to sertraline but no enduring differences beyond week 8 of treatments. Side effects, in particular dry mouth, constipation, tremors, sweating, and cardiovascular complaints increased more in severity and were more frequent and persistent during imipramine than sertraline but, except for the 10 beats/min increase in heart rate, side effects were clinically insignificant at the end of both treatments. Change in sexual complaints and weight did not differ between the treatments. The more favorable side effect profile of SSRIs versus TCAs was demonstrated even in the best case scenario of treatment completers. The more rapid improvement with imipramine needs replication but, tentatively, it may be attributed to the greater motivational effects toward action observed with noradrenergic or dual action antidepressants compared to SSRIs. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Clinical Psychiatry Springer Journals

Imiprmaine vs. Sertraline in Panic Disorder: 24-Week Treatment Completers

Mavissakalian, Matig
Annals of Clinical Psychiatry , Volume 15 (4) – Oct 11, 2004
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Publisher
Springer Journals
Copyright
Copyright © 2003 by American Academy of Clinical Psychiatrists
Subject
Medicine & Public Health; Neurology; Psychiatry; Psychopharmacology
ISSN
1040-1237
eISSN
1573-3238
DOI
10.1023/B:ACLI.0000008170.74985.b6
Publisher site
See Article on Publisher Site

Abstract

Despite the acknowledged favorable side effects profile of selective serotonin reuptake inhibitors (SSRIs), comparative studies have not found significant differences in efficacy between tricyclics (TCAs) such as imipramine and clomipramine, and SSRIs in the treatment of panic disorder. The present study focuses on treatment completers to inform patients who adhere to a recommended course of treatment on the possible differential patterns of improvement and of change in side effects between sertraline and imipramine. From an intent to treat consecutive sample of patients participating in the 24-week open phase protocolized treatment of a long-term controlled maintenance/discontinuation study, 20 imipramine completers and 16 sertraline completers with moderate to severe baseline symptomatology were compared using primarily repeated measures analysis of variance on measures of symptom severity, on 15 side effects systematically elicited using an inventory and on heart rate and weight. The results revealed greater early improvement with imipramine compared to sertraline but no enduring differences beyond week 8 of treatments. Side effects, in particular dry mouth, constipation, tremors, sweating, and cardiovascular complaints increased more in severity and were more frequent and persistent during imipramine than sertraline but, except for the 10 beats/min increase in heart rate, side effects were clinically insignificant at the end of both treatments. Change in sexual complaints and weight did not differ between the treatments. The more favorable side effect profile of SSRIs versus TCAs was demonstrated even in the best case scenario of treatment completers. The more rapid improvement with imipramine needs replication but, tentatively, it may be attributed to the greater motivational effects toward action observed with noradrenergic or dual action antidepressants compared to SSRIs.

Journal

Annals of Clinical Psychiatry – Springer Journals

Published: Oct 11, 2004

References

  • Collaborative Paroxetine Panic Study Investigators: A comparison of paroxetine, clomipramine, and placebo in the treatment of panic disorder
    Lecrubier, Y; Bakker, A; Dunbar, G; Judge, R
  • The effects of citalopram in panic disorder
    Wade, AG; Lepola, U; Koponen, HJ; Pedersen, V; Pedersen, T
  • A double-blind placebo-controlled trial comparing fluvoxamine and imipramine in the treatmentofpanicdisorderwithourwithoutagoraphobia
    Bakish, D; Hooper, CL; Fiteau, MJ; Charbonneau, Y; Fraser, G; Dixy, LW; Thibaudeau, C; Raine, D
  • Reliability and validity of the MINI international neuropsychiatric interview (M.I.N.I): according to the SCID-P
    Sheehan, DV; Lecrubier, Y; Harnett-Sheehan, K; Janavs, J; Weiller, E; Keskiner, A; Schinka, J; Knapp, E; Sheehan, MF; Dunbar, GC
  • A rating scale for depression
    Hamilton, M
  • Imipramine in panic disorder with agoraphobia: dose ranging and plasma level-response relationships
    Mavissakalian, MR; Perel, JM
  • Sertraline in the treatment of panic disorder
    Londborg, PD; Wolkow, R; Smith, WT
  • Gauging the effectiveness of extended imipramine treatment for panic disorder with agoraphobia
    Mavissakalian, MR; Perel, JM; Talbott-Green, M; Sloan, C
  • Long-term maintenance and discontinuation of imipramine therapy in panic disorder with agoraphobia
    Mavissakalian, MR; Perel, JM
  • Imipramine treatment of panic disorder with agoraphobia: The second time around
    Mavissakalian, MR; Perel, JM; de Groot, C.
  • Brief standard self-rating for phobic patients
    Marks, IM; Matthews, AM
  • An inventory for measuring depression
    Beck, AT; War, CH; Medelson, M; Mock, J; Erbaugh, J
  • Anxiety Sensitivity Index Revised Test Manual
    Peterson, RA; Reiss, S
  • Novel Antidepressant Strategies to Optimize Outcome (Academic Highlights)
    Montgomery, SA; Nelson, JC
  • Reboxetine, a selective norepinephrine reuptake inhibitor, is an effective and well-tolerated treatment for panic disorder
    Versiani, M; Cassana, G; Perugi, G; Benedetti, A; Mastalli, L; Nardi, A; Savino, M
  • The side effects burden of extended imipramine treatment of panic disorder
    Mavissakalian, MR; Perel, JM
  • Specific side effects of long-term imipramine management of panic disorder
    Mavissakalian, M; Perel, J; Guo, S
  • Sexual function in chronically depressed patients treated with SSRI antidepressants: A pilot study
    Piazza, LA; Markowitz, JC; Kocsis, JH; Leon, AC; Portera, L; Miller, NL; Adler, D
  • Serotonin reup-take antidepressant effects on sexual function in patients with anxiety disorders
    Labbate, LA; Grimes, JB; Arana, GW
  • Self-reported sexual dysfunctions in anxiety disorder patients
    Ware, MR; Emmanuel, NP; Johnson, MR; Brawman-Mintzer, O; Knapp, R; Crawford-Harrison, M; Lydiard, RB