Determinants of pharmacologic treatment failure in panic disorder

The Journal of Clinical Psychiatry
D S CowleyP P Roy-Byrne

Abstract

We systematically assessed reasons for failure of pharmacologic treatment for panic disorder in patients referred to a specialty anxiety and mood disorders clinic and examined possible determinants of treatment-resistant panic disorder. Interview data were obtained from 106 patients with DSM-III-R panic disorder seen in consultation. Data for each of 252 past medication trials included dose, duration of treatment, side effects, outcome, and reason for discontinuation. T tests and chi-square analyses were used to compare demographic and clinical characteristics of patients failing versus responding to adequate trials and those with and without intolerable medication side effects. Of 252 medication trials, 190 used effective antipanic medications, and only 59 (23%) were adequate in dose and duration. The most common reason for treatment failure was intolerable side effects, occurring in 51 (27%) of 190 trials using effective antipanic medications. Patients discontinuing treatment due to adverse effects had higher Hamilton Rating Scale for Anxiety scores and were less likely to have a history of substance abuse. Discontinuation due to side effects was significantly more common with tricyclic antidepressants than with benzodiazepin...Continue Reading

Citations

Oct 23, 2001·Depression and Anxiety·B R Slaap, J A den Boer
Mar 24, 2005·Depression and Anxiety·Michael HollifieldE H Uhlenhuth
Mar 3, 2007·Applied Psychophysiology and Biofeedback·Maria Katsamanis KaravidasAfton Hassett
Jun 8, 2001·Current Treatment Options in Neurology·Robert D. DaviesPaula D. Riggs
Mar 15, 2002·International Clinical Psychopharmacology·B R SlaapJ A den Boer
Jan 13, 2006·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Vladan Starcevic
Aug 30, 2008·Neuropsychiatric Disease and Treatment·Carlo Marchesi
Aug 2, 2008·Expert Review of Neurotherapeutics·Vladan Starcevic
Dec 19, 2014·Expert Opinion on Investigational Drugs·Jacob Raber, Robert M Duvoisin
Jan 9, 2003·The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry·Borwin BandelowUNKNOWN World Federation of Societies of Biological Psychiatry Task Force on Treatment Guidelines for Anxiety, Obsessive-Compulsive
Oct 25, 2008·The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry·Borwin BandelowJohann Vega
Aug 9, 2016·Progress in Neuro-psychopharmacology & Biological Psychiatry·A ChagraouiF Thibaut
Mar 7, 2012·The Australian and New Zealand Journal of Psychiatry·Steven MoylanMichael Berk
Jul 6, 2004·Acta Psychiatrica Scandinavica·C ToniH S Akiskal
May 9, 2018·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Saurabh KumarNand Kumar
Oct 21, 2006·The Cochrane Database of Systematic Reviews·J C IpserD J Stein
Jul 19, 2006·Molecular Psychiatry·A Bystritsky
Jun 25, 2019·Depression and Anxiety·Wicher A BokmaAnton L J M van Balkom
Sep 23, 2014·Expert Review of Neurotherapeutics·Vladan Starcevic
Feb 9, 2000·The Journal of Nervous and Mental Disease·E L ScottJ J Worthington

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anxiety Disorders

Discover the latest research on anxiety disorders including agoraphobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder here.