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Cited by 56Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesCardiac Health and Mental HealthMaternal Mental Health During Pregnancy and Postpartum

A Randomized, Naturalistic, Parallel-Group Study for the Long-Term Treatment of Panic Disorder With Clonazepam or Paroxetine

Nardi, Antonio E., Freire, Rafael C., Mochcovitch, Marina D., Amrein, Roman, Levitan, Michelle N., King, Anna L., Valença, Alexandre M., Veras, André B. +14 more·2012·Journal of Clinical Psychopharmacology
DOI 10.1097/jcp.0b013e31823fe4bd
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Abstract

This long-term extension of an 8-week randomized, naturalistic study in patients with panic disorder with or without agoraphobia compared the efficacy and safety of clonazepam (n = 47) and paroxetine (n = 37) over a 3-year total treatment duration. Target doses for all patients were 2 mg/d clonazepam and 40 mg/d paroxetine (both taken at bedtime). This study reports data from the long-term period (34 months), following the initial 8-week treatment phase. Thus, total treatment duration was 36 months. Patients with a good primary outcome during acute treatment continued monotherapy with clonazepam or paroxetine, but patients with partial primary treatment success were switched to the combination therapy. At initiation of the long-term study, the mean doses of clonazepam and paroxetine were 1.9 (SD, 0.30) and 38.4 (SD, 3.74) mg/d, respectively. These doses were maintained until month 36 (clonazepam 1.9 [SD, 0.29] mg/d and paroxetine 38.2 [SD, 3.87] mg/d). Long-term treatment with clonazepam led to a small but significantly better Clinical Global Impression (CGI)-Improvement rating than treatment with paroxetine (mean difference: CGI-Severity scale -3.48 vs -3.24, respectively, P = 0.02; CGI-Improvement scale 1.06 vs 1.11, respectively, P = 0.04). Both treatments similarly reduced the number of panic attacks and severity of anxiety. Patients treated with clonazepam had significantly fewer adverse events than those treated with paroxetine (28.9% vs 70.6%, P < 0.001). The efficacy of clonazepam and paroxetine for the treatment of panic disorder was maintained over the long-term course. There was a significant advantage with clonazepam over paroxetine with respect to the frequency and nature of adverse events.

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Crossref · 10.1097/jcp.0b013e31823fe4bd

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  • Other studies found significant improvement in panic disorder over the course of long-term pharmacotherapy beyond that obtained with short-term treatment with the same medications.

    “These results are consistent with other studies that found significant improvement in patients with PD over the course of long-term pharmacotherapy beyond that obtained with short-term treatment with the same medications [39–41].”

    From Management of Treatment-Resistant Panic Disorder (2017) · cites this paper as [41]

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Authors
Nardi, A. E., Freire, R. C., Mochcovitch, M. D., Amrein, R., Levitan, M. N., King, A. L., Valença, A. M., Veras, A. B., Paes, F., Sardinha, A., Nascimento, I., de-Melo-Neto, V. L., Dias, G. P., e Silva, A. C. D. O., Soares-Filho, G. L., da Costa, R. T., Mezzasalma, M. A., de Carvalho, M. R., de Cerqueira, A. C., Hallak, J. E., Crippa, J. A., & Versiani, M.
ORCID
Venue
Journal of Clinical Psychopharmacology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-02
Volume
32
Issue
1
Pages
120-126
ISSN
0271-0749 (ISSN-L)
DOI
10.1097/jcp.0b013e31823fe4bd
OpenAlex
W2067927385
Cited by
56
References
30
Citations by year
2025: 1 · 2024: 2 · 2023: 7 · 2022: 5 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 8 · 2017: 6 · 2016: 6 · 2015: 6 · 2014: 4 · 2013: 3 · 2012: 2
FWCI
3.72
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Clinical Psychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
  • Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords
panic disorder, agoraphobia, clonazepam, paroxetine, long-term treatment, maintenance therapy, adverse events, treatment efficacy, combination therapy, benzodiazepines, selective serotonin reuptake inhibitors, panic attacks
MeSH terms
Adolescent, Adult, Anticonvulsants, Brazil, Clonazepam, Drug Therapy, Combination, Female, Humans, Interview, Psychological, Long-Term Care, Male, Middle Aged, Personality Inventory, Prospective Studies, Panic Disorder, Selective Serotonin Reuptake Inhibitors, Paroxetine, Retreatment, Young Adult

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