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Protective effects of imipramine maintenance in panic disorder with agoraphobia
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Protective effects of imipramine maintenance in panic disorder with agoraphobia
M a v i s s a k a l i a n , M. 1 a n d P e r e l , J.M.
1Department of Psychiatry, The Ohio State University College of Medicine, 473 West 12th Avenue, Columbus, OH 43210, U.S.A. Key words: Panic/agoraphobia; Imipramine maintenance; Relapse
Recent findings from our center demonstrate that imipramine has specific and clinically significant effects in the treatment of panic disorder with agoraphobia and underscore the importance of pharmacologic prophylaxis to prevent relapse and enhance long-term outcome. In the present study we assess the potential protective effects of imipramine maintenance treatment against relapse by comparing the differential relapse rates following discontinuation of Acute (6 months) and Acute plus Maintenance (18 months) imipramine treatments. Sixteen patients with panic disorder with agoraphobia, who had shown marked and stable response to six months of Acute Treatment and a comparable group of 14 patients who had been in remission during an additional year of half-dose imipramine maintenance entered a three month, double-blind discontinuation study, followed by a three-month, drug free period. Assessments included operationalized response/relapse criteria and plasma drug concentrations which showed high compliance with the experimental conditions. Survival analysis revealed significantly different cumulative probabilities of continued response six months after discontinuation of Acute (0.21) and Maintenance (0.77) imipramine treatments. These results suggest that in addition to it's prophylactic effects, successful imipramine maintenance of panic/agoraphobia patients may have protective effects against relapse, at least in the first six months of the post-maintenance period. References
Mavissakalian, M. and Perel, I. (1989), Imipramine dose-response relationship in panic disorder with agoraphobia. Arch. Gen. Psychiatry 46, 127-131. Mavissakalian, M. and Perel, L (in press), Clinical experiments in maintenance and discontinuation of imipramine in panic disorder with agoraphobia. Arch. Gen. Psychiatry.
Predictors for longterm use of benzodiazepines
Whitworth, A.B., Bamas, C. and Fleischhacker,W.W. Innsbruck University Clinics, Dept. of Psychiatry, A-6020 lnnsbruck, Austria Key words: Benzodiazepines; Longterm use; Predictors
We interviewed a sample of 171 benzodiazepine (BZD)-users in early 1988. The investigated sample consisted of 51 males and 120 females with a mean age of 57.7 years (sd - 16.03). The mean duration of BZD intake up to this investigation was 4.5 years (sd-4.0), the mean daily dosage was 7.65 mg diazepam equivalent (DE) (sd - 11.5). During the last three months of 1991 a follow up study was performed: Of the 171 subjects examined in 1988, 8 (4.7%)
Protective effects of imipramine maintenance in panic disorder with agoraphobia
M a v i s s a k a l i a n , M. 1 a n d P e r e l , J.M.
1Department of Psychiatry, The Ohio State University College of Medicine, 473 West 12th Avenue, Columbus, OH 43210, U.S.A. Key words: Panic/agoraphobia; Imipramine maintenance; Relapse
Recent findings from our center demonstrate that imipramine has specific and clinically significant effects in the treatment of panic disorder with agoraphobia and underscore the importance of pharmacologic prophylaxis to prevent relapse and enhance long-term outcome. In the present study we assess the potential protective effects of imipramine maintenance treatment against relapse by comparing the differential relapse rates following discontinuation of Acute (6 months) and Acute plus Maintenance (18 months) imipramine treatments. Sixteen patients with panic disorder with agoraphobia, who had shown marked and stable response to six months of Acute Treatment and a comparable group of 14 patients who had been in remission during an additional year of half-dose imipramine maintenance entered a three month, double-blind discontinuation study, followed by a three-month, drug free period. Assessments included operationalized response/relapse criteria and plasma drug concentrations which showed high compliance with the experimental conditions. Survival analysis revealed significantly different cumulative probabilities of continued response six months after discontinuation of Acute (0.21) and Maintenance (0.77) imipramine treatments. These results suggest that in addition to it's prophylactic effects, successful imipramine maintenance of panic/agoraphobia patients may have protective effects against relapse, at least in the first six months of the post-maintenance period. References
Mavissakalian, M. and Perel, I. (1989), Imipramine dose-response relationship in panic disorder with agoraphobia. Arch. Gen. Psychiatry 46, 127-131. Mavissakalian, M. and Perel, L (in press), Clinical experiments in maintenance and discontinuation of imipramine in panic disorder with agoraphobia. Arch. Gen. Psychiatry.
Predictors for longterm use of benzodiazepines
Whitworth, A.B., Bamas, C. and Fleischhacker,W.W. Innsbruck University Clinics, Dept. of Psychiatry, A-6020 lnnsbruck, Austria Key words: Benzodiazepines; Longterm use; Predictors
We interviewed a sample of 171 benzodiazepine (BZD)-users in early 1988. The investigated sample consisted of 51 males and 120 females with a mean age of 57.7 years (sd - 16.03). The mean duration of BZD intake up to this investigation was 4.5 years (sd-4.0), the mean daily dosage was 7.65 mg diazepam equivalent (DE) (sd - 11.5). During the last three months of 1991 a follow up study was performed: Of the 171 subjects examined in 1988, 8 (4.7%)