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 .
Controlled trials of inositol in psychiatry
Inositol is a simple polyol precursor in a second messenger system important in the brain . Cerebrospinal fluid inositol has been reported as decreased in depression . A double-blind controlled trial of 12 g daily of inositol in 28 depressed patients for four weeks was performed . Significant overall benefit for inositol compared to placebo was found at week 4 on the Hamilton Depression Scale . No changes were noted in hematology , kidney or liver function . Since many antidepressants are effective in panic disorder , twenty-one patients with panic disorder with or without agoraphobia completed a double-blind , placebo-controlled , four week , r and om-assignment crossover treatment trial of inositol 12 g per day . Frequency and severity of panic attacks and severity of agoraphobia declined significantly with inositol compared to placebo .  Side-effects were minimal . Since serotonin re-uptake inhibitors benefit obsessive compulsive disorder ( OCD ) and inositol is reported to reverse desensitization of serotonin receptors , thirteen patients with OCD completed a double-blind controlled crossover trial of 18 g inositol or placebo for six weeks each . Inositol significantly reduced scores of OCD symptoms compared with placebo . A controlled double-blind crossover trial of 12 g daily of inositol for a month in twelve anergic schizophrenic patients , did not show any beneficial effects . A double-blind controlled crossover trial of 6 g of inositol daily vs. glucose for one month each was carried out in eleven Alzheimer patients , with on clearly significant therapeutic effects . Antidepressant drugs have been reported to improve attention deficit disorder ( ADDH ) with hyperactivity symptomatology . We studied oral inositol in children with ADDH in a double-blind , crossover , placebo-controlled manner . Eleven children , mean age 8.9 + /- 3.6 years were enrolled in an eight week trial of inositol or placebo at a dose of 200 mg/kg body weight . Results show a trend for aggravation of the syndrome with myo-inositol as compared to placebo . Recent studies suggest that serotonin re-uptake inhibitors are helpful in at least some symptoms of autism . However a controlled double-blind crossover trial of inositol 200 mg/kg per day showed no benefit in nine children with autism . Cholinergic agonists have been reported to ameliorate electroconvulsive therapy (ECT)-induced memory impairment . Inositol metabolism is involved in the second messenger system for several muscarinic cholinergic receptors . Inositol 6 g daily was given in a crossover-double-blind manner for five days before the fifth or sixth ECT to a series of twelve patients , without effect . These results suggest that inositol has therapeutic effects in the spectrum of illness responsive to serotonin selective re-uptake inhibitors , including depression , panic and OCD , and is not beneficial in schizophrenia , Alzheimer 's ADDH , autism or ECT-induced cognitive impairment
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 .