MAINTENANCE DRUG-THERAPY OF PANIC DISORDER

The efficacy of tricyclics and benzodiazepines in the short term (appr oximately 2-4 months) treatment of panic disorder is well demonstrated , but efficacy over the longer term is not considered established. The present study provided systematic data from a double blind comparison of maintenance therapy (up to 8 months) of panic disorder with or wit hout agoraphobia with alprazolam, imipramine, or placebo in 181 patien ts who had responded to the same regimen in a randomized 8-week treatm ent trial. All three groups had improved during the first 2 months (ac tive treatments more than placebo and about equal to each other), and all maintained or extended their improvement over the next 6 months wi thout any significant change in dose. More than twice as many alprazol am and imipramine than placebo patients (15%) remained in treatment fo r the full 8 months and did slightly better on symptom measures than t he remaining placebo patients. Both medications were well tolerated du ring the maintenance period. The data suggest sustained efficacy and s afety of imipramine and alprazolam over an extended period. More speci fically, they suggest that tolerance does not develop to the therapeut ic effects of either drug.