Paroxetine , sertraline , citalopram , escitalopram , and clomipramine showed the most consistent results , while fluvoxamine , fluoxetine , and imipramine showed limited efficacy .
Preliminary results suggested the potential efficacy of inositol ; D-cycloserine showed mixed results for its ability to improve the outcome of exposure-based cognitive behavioral therapy .
No studies have been specifically oriented toward evaluating the effect of drugs on AG ; in the available studies , the improvement of AG might have been the consequence of the reduction of panic attacks .
BACKGROUND Although there are controversial issues ( the " American view " and the " European view " ) regarding the construct and definition of agoraphobia ( AG ) , this syndrome is well recognized and it is a burden in the lives of millions of people worldwide .
To better clarify the role of drug therapy in AG , the authors summarized and discussed recent evidence on pharmacological treatments , based on clinical trials available from 2000 , with the aim of highlighting pharmacotherapies that may improve this complex syndrome .
Crossover trial of pagoclone and placebo in patients with DSM-IV panic disorder
Pagoclone is a cyclopyrrolone that is believed to act as a partial agonist at the γ-aminobutyric acid ( GABA ) A/benzodiazepine ( BDZ ) receptor . In theory , such partial agonists should be anxiolytic but lack the adverse side-effects of sedation , tolerance and withdrawal associated with full GABA-A/BDZ agonists . The objective of the r and omized double-blind crossover study was to assess whether pagoclone was an effective anti-panic agent and also to assess its side-effect profile . Patients recruited had a diagnosis of Panic Disorder ( DSM-IV ) with at least one panic attack per week . Following a 2-week screening period , patients entered a 6-week trial consisting of two 2-week treatment periods , each followed by a 1-week washout . Patients were r and omly assigned to receive either pagoclone 0.1 mg t.d.s . or placebo on their first treatment period and the converse on their second . The primary measure was daily panic attack dairy . Fourteen patients completed the study , the mean number of panic attacks during screening was 5.8 ± 0.8 ( SEM ) , this fell to 3.6 ± 0.5 during treatment with pagoclone ( p = 0.05 ) and 4.3 ± 0.8 with placebo ( p = 0.14 ) . There was no significant difference on direct comparison of pagoclone with placebo or in any of the secondary measures ( including Rickels withdrawal scale ) or the adverse event profiles . The study provides preliminary evidence that pagoclone has anxiolytic properties in the absence of typical BDZ side-effects . This is consistent with its theoretical mode of action as a partial agonist at the GABAA/BDZ receptor
Paroxetine , sertraline , citalopram , escitalopram , and clomipramine showed the most consistent results , while fluvoxamine , fluoxetine , and imipramine showed limited efficacy .
Preliminary results suggested the potential efficacy of inositol ; D-cycloserine showed mixed results for its ability to improve the outcome of exposure-based cognitive behavioral therapy .
No studies have been specifically oriented toward evaluating the effect of drugs on AG ; in the available studies , the improvement of AG might have been the consequence of the reduction of panic attacks .
BACKGROUND Although there are controversial issues ( the " American view " and the " European view " ) regarding the construct and definition of agoraphobia ( AG ) , this syndrome is well recognized and it is a burden in the lives of millions of people worldwide .
To better clarify the role of drug therapy in AG , the authors summarized and discussed recent evidence on pharmacological treatments , based on clinical trials available from 2000 , with the aim of highlighting pharmacotherapies that may improve this complex syndrome .