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Cited by 23Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesSchizophrenia research and treatmentCardiac Health and Mental Health

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Adverse effects associated with the short-term treatment of panic disorder with imipramine, alprazolam or placebo

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Cassano, Giovanni B., Toni, Cristina, Petracca, Alberto, Deltito, Joseph, Benkert, Otto, Curtis, George, Hippius, H., Maier, Wolfgang, Shera, David, Klerman, Gerald·1994·European Neuropsychopharmacology
DOI 10.1016/0924-977x(94)90314-x
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Abstract

Side effects play a significant role in the selection of drugs to be used in panic disorder/agoraphobia whose polyphobic symptomatology often includes a suspiciousness about taking drugs and a fear of undesired side effects which may lead to the refusal of treatment. The safety, side effects and patients' acceptance of alprazolam and imipramine versus placebo were evaluated in 1168 subjects with panic disorder/agoraphobia who had been enrolled in the second phase of the Upjohn World Wide Panic Study. Side effects that worsened over baseline to a greater extent with alprazolam than with imipramine and placebo were sedation, fatigue/weakness, memory problems, ataxia and slurred speech. In the imipramine group blurred vision, tachycardia/palpitations, insomnia, sleep disturbance, excitement/nervousness, malaise, dizziness/faintness, headache, nausea/vomiting and decrease in appetite were worse than in the other groups. In the placebo group the anxious symptoms were most prominent. The highest level of compliance was shown in the alprazolam-treated group and the lowest in the placebo-treated group. Strong predictors of side effects were not observed. If a side effect profile is known, it will be easier for a clinician to choose the right drug and the appropriate management by taking into account compliance, safety and efficacy in each patient under treatment. Further information about side effects in long-term maintenance treatment would be of great clinical pertinence in ensuring safety and enhancing patients' quality of life.

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  • In patients with panic disorder or agoraphobia, imipramine (25-250mg) was associated with more sedation than placebo (although less than alprazolam; 110mg), but significantly more insomnia than placebo and alprazolam.

    “In a study of patients reporting panic disorder or agoraphobia, (Cassano et al., 1994) imipramine (25-250mg) was associated with more sedation than placebo (although less than alprazolam; 110mg), but significantly more insomnia than placebo and alprazolam.”

    From Antidepressants and their effect on sleep (2005) · cites this paper as Cassano et al., 1994

    The Abstract (page unavailable) reports greater sedation with alprazolam and worse insomnia with imipramine than with the other groups. Table 1 shows imipramine sedation above placebo at weeks 1 and 4, but not week 8; it also does not establish the claimed significantly greater insomnia than placebo throughout treatment. Subjects and method specifies 1-mg alprazolam capsules, up to 10 per day, not 110 mg. (LLM, conf=0.88)

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Citations

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Research works printed but not linked: 31

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Metadata

Authors
Cassano, G. B., Toni, C., Petracca, A., Deltito, J., Benkert, O., Curtis, G., Hippius, H., Maier, W., Shera, D., & Klerman, G.
Affiliations
  • University of Pisa (IT)
  • Cornell University (US)
  • Johannes Gutenberg University Mainz (DE)
  • University of Michigan (US)
  • Ludwig-Maximilians-Universität München (DE)
Corresponding author
Cassano, Giovanni B.
ORCID
Venue
European Neuropsychopharmacology
Publisher
Elsevier BV
Published
1994-03
Volume
4
Issue
1
Pages
47-53
ISSN
0924-977X (ISSN-L)
DOI
10.1016/0924-977x(94)90314-x
OpenAlex
W2150282586
Cited by
23
References
2
Citations by year
2025: 1 · 2022: 1 · 2019: 2 · 2018: 1 · 2016: 2 · 2015: 1 · 2012: 1
FWCI
0.88
Type
journal article
Language
en
Open access
Licence
Locations
  • European Neuropsychopharmacology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
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 › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
panic disorder, agoraphobia, imipramine, alprazolam, adverse drug reactions, drug safety, medication adherence, sedation, placebo comparison, short-term treatment
MeSH terms
Adolescent, Adult, Aged, Alprazolam, Double-Blind Method, Humans, Imipramine, Middle Aged, Patient Compliance, Psychiatric Status Rating Scales, Panic Disorder

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