Potential effectiveness and safety of olanzapine in refractory panic disorder
Open accessAbstract
Panic disorder is a common and disabling psychiatric disorder. Despite treatment advances, refractory panic disorder requires novel interventions. One such pharmacologic intervention with theoretical and case study support includes olanzapine, a thienobenzodiazepine medication currently approved for schizophrenia in the United States. Ten people with refractory DSM-IV diagnosed panic disorder completed an 8-week, open-label, flexible-dose clinical trial. Baseline, in-treatment, and end-of-treatment data for panic attacks, anticipatory anxiety, phobic avoidance, and impairment were collected. Data were analyzed using SPSS software. Refractory panic disorder patients required a wide dose range averaging 12.3 mg/day of olanzapine to significantly improve or ablate panic attacks. On the average, number of attacks decreased from 6.1/week at baseline to 1.1/week at the end of treatment, and anticipatory anxiety from 32% of the day to 8% of the day. At treatment end, 5 of 10 participants (50%) were panic free, 4 (40%) had one attack in the previous week, 1 (10%) had seven attacks in the previous week, and 6 of 10 participants (60%) were anticipatory anxiety free. There were also statistically and clinically significant improvements in impairment over the course of the trial. There were no significant changes in vital signs, emergent side effects, or average weight, although 6 of 10 people did gain weight. Olanzapine is potentially effective and safe in panic disorder. Due to study limitations, further clinical trials are needed to demonstrate effectiveness.
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There is no unequivocal definition of treatment-resistant panic disorder, and very heterogeneous criteria have been used across studies, making interpretation of results uncertain.
“Currently, there is no unequivocal definition of TRPD. Very heterogeneous criteria have been used across different studies, making interpretation of the results uncertain.”
From Management of Treatment-Resistant Panic Disorder (2017) · cites this paper as [18]
The Introduction says that “refractory” or “treatment resistance” is not well defined. The Discussion says this study’s criterion for a failed medication trial may have differed from those in other studies, but it does not establish that criteria were very heterogeneous across studies or explicitly link that variation to uncertain interpretation of results. The indexed passages provide no page numbers. (LLM, conf=0.86)
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References 51 · Cited by 58
Research works printed but not linked: 1
- Zaubler TS, Katon W. 1996. Panic disorder and medical comorbid- ity: A review of the medical and psychiatric literature. Bull Menninger Clin 60(Suppl):A12-A38.
- Authors
- Hollifield, M., Thompson, P. M., Ruiz, J. E., & Uhlenhuth, E. H.
- Affiliations
- University of New Mexico (US)
- The University of Texas at San Antonio Health Science Center (US)
- Corresponding author
- Hollifield, Michael
- ORCID
- Hollifield, Michael
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2005
- Volume
- 21
- Issue
- 1
- Pages
- 33-40
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W1984499598
- Cited by
- 58
- References
- 51
- Citations by year
- 2025: 1 · 2024: 4 · 2022: 1 · 2021: 3 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 3 · 2012: 5
- FWCI
- 7.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- olanzapine, atypical antipsychotics, panic attacks, anticipatory anxiety, phobic avoidance, functional disability, weight gain, drug safety
- MeSH terms
- Olanzapine, Adult, Benzodiazepines, Drug Administration Schedule, Female, Humans, Male, Severity of Illness Index, Panic Disorder, Selective Serotonin Reuptake Inhibitors, Diagnostic and Statistical Manual of Mental Disorders
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