RESUMO
This article reviews all available studies reported in the literature or presented at national or international meetings on the efficacy of serotonin selective reuptake inhibitors and less selective serotonin uptake inhibitors in panic disorder. The research data lags behind-rather than leads-experience in everyday clinical practice. The emerging data suggest that serotonin uptake inhibitors are superior to placebo and better tolerated than most of the older alternatives. As a result they are now becoming first-choice treatments in panic disorder.
Assuntos
Transtorno de Pânico/tratamento farmacológico , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , 1-Naftilamina/análogos & derivados , 1-Naftilamina/uso terapêutico , Citalopram/uso terapêutico , Ensaios Clínicos como Assunto , Clomipramina/uso terapêutico , Fluoxetina/uso terapêutico , Fluvoxamina/uso terapêutico , Humanos , Transtorno de Pânico/psicologia , Paroxetina/uso terapêutico , Sertralina , Resultado do TratamentoRESUMO
The frequent occurrence of desynchrony between psychiatric symptoms and disability makes it necessary to measure disability/ functional impairment in addition to psychiatric symptoms when tracking treatment outcome. Existing disability measures in psychiatry are comprehensive but lengthy. There is a need for short, simple, cost-effective, sensitive measures of disability and functional impairment in psychiatric disorders. We developed a discretized analog disability scale (DISS) which uses visual-spatial, numeric and verbal descriptive anchors to assess disability across three domains: work, social life and family life. The DISS has proved to be very sensitive to change in drug treatment studies in psychiatry. The usefulness of the DISS in assessing disability in terms of work, social and family relationships is discussed.
Assuntos
Avaliação da Deficiência , Transtornos Fóbicos/diagnóstico , HumanosRESUMO
This 8-week double-blind placebo-controlled trial investigated the relative efficacy and safety of alprazolam and buspirone in the treatment of panic disorder. Alprazolam (mean +/- SD dose 5.2 +/- 2.6 mg) produced a rapid and sustained improvement in panic attacks, anxiety, phobias, and disability and was superior to buspirone (mean +/- SD dose 61 +/- 26.5 mg) and placebo on all of these measures on completer (n = 85) and endpoint analysis (n = 92). Although higher doses of buspirone were used in this study than in previous trials, buspirone was not superior to placebo on any of the outcome measures. The results were disappointing in light of buspirone's benign side effect profile and low abuse potential.