The efficacy of azapirones is uncertain due to the lack of meta-analysable data for the primary outcome and low- quality evidence for secondary efficacy outcomes .
A small amount of moderate- quality evidence suggested that the acceptability of azapirones for panic disorder was lower than for placebo .
If further research is to be conducted , studies with larger sample sizes , with different azapirones and with less risk of bias are necessary to draw firm conclusions regarding azapirones for panic disorder
BACKGROUND Panic disorder is common in the general population .
It is often associated with other psychiatric disorders , such as drug dependence , major depression , bipolar disorder , social phobia , specific phobia and generalised anxiety disorder .
Azapirones are a class of drugs used as anxiolytics .
They are associated with less drowsiness , psychomotor impairment , alcohol potentiation and potential for addiction or abuse than benzodiazepines .
However , azapirones are not widely used in the treatment of panic disorder and evidence for their efficacy is unclear .
It is important to find out if azapirones are effective and acceptable in the treatment of panic disorder .
OBJECTIVES To assess the effects of azapirones on panic disorder in adults , specifically:1 .
to determine the efficacy of azapirones in alleviating symptoms of panic disorder , with or without agoraphobia , in comparison with placebo;2 .
to review the acceptability of azapirones in panic disorder , with or without agoraphobia , in comparison with placebo ; and 3 .
to investigate adverse effects of azapirones in panic disorder with or without agoraphobia , including general prevalence of adverse effects , compared with placebo .
Smoking Modulates Neuroendocrine Responses to Ipsapirone in Patients with Panic Disorder
Reduced 5-HT1A-receptor responsiveness has been reported in patients with panic disorder(PD ) and /or agoraphobia ( PDA ) . Although many of these patients are regular smokers , it has not been examined whether psychological or neurobiological effects induced by the selective 5-HT1A-receptor agonist , ipsapirone , are affected by the smoking status of the patients .In order to clarify this question neuroendocrine challenges with oral doses of ipsapirone ( 0.3 mg/kg ) and placebo were performed in 39 patients with PDA , and results were compared between patients who smoked ( > 10 cigarettes per day , n = 17 ) and patients who had been non-smokers for at least two years ( n = 22 ) . Patients who were smokers ( but did not smoke during the challenge procedure ) had significantly reduced baseline concentrations of cortisol and a significantly lower body temperature . In comparison to placebo , administration of ipsapirone was associated with significant increases of various psychological symptoms and plasma cortisol concentrations . The subgroup of PD patients who were smokers showed significantly higher cortisol responses to ipsapirone than non-smokers . In conclusion , smoking status has to be taken into account when assessing the responsiveness of 5-HT1A receptors in patients with psychiatric disorders . The prevention of smoking during challenge sessions might not be the ideal approach in heavy smokers , since sudden abstinence from smoking is likely to affect neurobiological and possibly psychological responses to ipsapirone
The efficacy of azapirones is uncertain due to the lack of meta-analysable data for the primary outcome and low- quality evidence for secondary efficacy outcomes .
A small amount of moderate- quality evidence suggested that the acceptability of azapirones for panic disorder was lower than for placebo .
If further research is to be conducted , studies with larger sample sizes , with different azapirones and with less risk of bias are necessary to draw firm conclusions regarding azapirones for panic disorder
BACKGROUND Panic disorder is common in the general population .
It is often associated with other psychiatric disorders , such as drug dependence , major depression , bipolar disorder , social phobia , specific phobia and generalised anxiety disorder .
Azapirones are a class of drugs used as anxiolytics .
They are associated with less drowsiness , psychomotor impairment , alcohol potentiation and potential for addiction or abuse than benzodiazepines .
However , azapirones are not widely used in the treatment of panic disorder and evidence for their efficacy is unclear .
It is important to find out if azapirones are effective and acceptable in the treatment of panic disorder .
OBJECTIVES To assess the effects of azapirones on panic disorder in adults , specifically:1 .
to determine the efficacy of azapirones in alleviating symptoms of panic disorder , with or without agoraphobia , in comparison with placebo;2 .
to review the acceptability of azapirones in panic disorder , with or without agoraphobia , in comparison with placebo ; and 3 .
to investigate adverse effects of azapirones in panic disorder with or without agoraphobia , including general prevalence of adverse effects , compared with placebo .