These drugs were better tolerated than tricyclics and benzodiazepines as they had a low risk of dependence and overdosing complications .
The serotonergic , noradrenergic and GABAergic pathways play a major role in the fear network and in the physiopathology of PD .
INTRODUCTION Panic disorder ( PD ) is a prevalent psychiatric disorder characterized by unexpected and recurrent panic attacks .
PD patients present significant psychosocial impairment and a high risk of psychiatric comorbidities and suicide .
PD should be treated effectively as soon as the symptoms emerge because the longer these patients remain without treatment , the worse the prognosis will be .
SSRIs and SNRIs are the first-line compounds in the treatment of PD .
Sertraline versus paroxetine in the treatment of panic disorder: an acute, double-blind noninferiority comparison.
OBJECTIVE Several classes of medications have demonstrated efficacy in panic disorder , but direct comparison of 2 proven treatments is still uncommon . The purpose of this study was to compare sertraline and paroxetine in the acute treatment of panic disorder . METHOD Adult out patients with panic disorder with or without agoraphobia ( DSM-IV and ICD-10 criteria ) were r and omly assigned in double-blind fashion to 12 weeks of treatment with flexible doses of sertraline ( titrated up to 50 - 150 mg/day ; N = 112 ) or paroxetine ( titrated up to 40 - 60 mg/day ; N = 113 ) . Patients were then tapered off medication over 3 weeks . The primary analysis was a noninferiority analysis of Panic and Agoraphobia Scale ( PAS ) scores . Secondary measures included panic attack frequency and the Clinical Global Impressions-Improvement scale ( CGI-I ) ( with responders defined as those with a CGI-I score < or = 2 ) . Data were collected from January 2000 to June 2001 . RESULTS Sertraline and paroxetine were associated with equivalent levels of improvement on the PAS total score , as well as on all secondary outcome measures . Eighty-two percent of patients taking sertraline versus 78 % of those taking paroxetine were CGI-I responders at endpoint . Numerically more patients on paroxetine treatment compared with sertraline treatment discontinued due to adverse events ( 18 % vs. 12 % ; NS ) , and a significantly higher proportion of paroxetine patients showed > or = 7 % weight gain ( 7 % vs. < 1 % ; p < .05 ) . During the taper period , the proportion of panic-free patients increased by 4 % with sertraline but decreased by 11 % with paroxetine ( p < .05 ) . CONCLUSION Sertraline and paroxetine had equivalent efficacy in panic disorder , but sertraline was significantly better tolerated and was associated with significantly less clinical worsening during taper than paroxetine
These drugs were better tolerated than tricyclics and benzodiazepines as they had a low risk of dependence and overdosing complications .
The serotonergic , noradrenergic and GABAergic pathways play a major role in the fear network and in the physiopathology of PD .
INTRODUCTION Panic disorder ( PD ) is a prevalent psychiatric disorder characterized by unexpected and recurrent panic attacks .
PD patients present significant psychosocial impairment and a high risk of psychiatric comorbidities and suicide .
PD should be treated effectively as soon as the symptoms emerge because the longer these patients remain without treatment , the worse the prognosis will be .
SSRIs and SNRIs are the first-line compounds in the treatment of PD .