Longitudinal outcome with pharmacotherapy in a naturalistic study of panic disorder

Naomi M. Simon, Steven Safren, Michael W. Otto, Saumya G. Sharma, Gretchen D. Lanka, Mark H. Pollack

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: Current recommendations suggest that pharmacotherapy for patients with panic disorder should be continued for at least 1 year [Am. J. Psychiatry 155 (1998) 1], despite a paucity of data systematically examining outcome for periods greater than 3-6 months. It is critically important to obtain more information on the effectiveness of medications over time for patients who initially responded to pharmacotherapy for panic disorder. Methods: Long-term outcome was examined for 78 patients who attained a 2-month period of sustained remission on medication and received maintenance pharmacotherapy for up to 24 months during the Massachusetts General Hospital Longitudinal Study of Panic Disorder, a prospective, naturalistic study. Participants were categorized by their maintenance treatment condition at remission: benzodiazepine alone (N=45, 58%), antidepressant alone (N=12, 16%), and combined treatment with a benzodiazepine and an antidepressant (N=21, 27%). Results: Approximately half (N=36, 46%) of the patients who had achieved remission relapsed at some time over the 2-year naturalistic study period, despite continued and adequate pharmacotherapy. There was no difference in timing or frequency of relapse by type of maintenance pharmacotherapy. Limitations: Interpretation of the data is limited by the naturalistic nature of the study, and by the relatively low sample size.Conclusions: This data suggests that patients with panic disorder have a high rate of relapse even after acute response to pharmacotherapy, despite continued treatment. In addition, the use of combined pharmacotherapy with antidepressants and benzodiazepines does not appear to provide greater protection from relapse than monotherapy.

Original languageEnglish (US)
Pages (from-to)201-208
Number of pages8
JournalJournal of Affective Disorders
Volume69
Issue number1-3
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Panic Disorder
Drug Therapy
Benzodiazepines
Antidepressive Agents
Recurrence
Maintenance
General Hospitals
Sample Size
Psychiatry
Longitudinal Studies
Therapeutics
Prospective Studies

Keywords

  • Outcome
  • Panic
  • Panic disorder
  • Pharmacotherapy
  • Relapse
  • Remission

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Behavioral Neuroscience
  • Biological Psychiatry
  • Neurology
  • Psychology(all)

Cite this

Longitudinal outcome with pharmacotherapy in a naturalistic study of panic disorder. / Simon, Naomi M.; Safren, Steven; Otto, Michael W.; Sharma, Saumya G.; Lanka, Gretchen D.; Pollack, Mark H.

In: Journal of Affective Disorders, Vol. 69, No. 1-3, 2002, p. 201-208.

Research output: Contribution to journalArticle

Simon, Naomi M. ; Safren, Steven ; Otto, Michael W. ; Sharma, Saumya G. ; Lanka, Gretchen D. ; Pollack, Mark H. / Longitudinal outcome with pharmacotherapy in a naturalistic study of panic disorder. In: Journal of Affective Disorders. 2002 ; Vol. 69, No. 1-3. pp. 201-208.
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