ADVERSE-EFFECTS ASSOCIATED WITH THE SHORT-TERM TREATMENT OF PANIC DISORDER WITH IMIPRAMINE, ALPRAZOLAM OR PLACEBO

Side effects play a significant role in the selection of drugs to be u sed in panic disorder/agoraphobia whose polyphobic symptomatology ofte n 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 ver sus placebo were evaluated in 1168 subjects with panic disorder/agorap hobia who had been enrolled in the second phase of the Upjohn World Wi de 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, s leep disturbance, excitement/nervousness, malaise, dizziness/faintness , headache, nausea/vomiting and decrease in appetite were worse than i n the other groups. In the placebo group the anxious symptoms were mos t prominent. The highest level of compliance was shown in the alprazol am-treated group and the lowest in the placebo-treated group. Strong p redictors 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 a nd the appropriate management by taking into account compliance, safet y and efficacy in each patient under treatment. Further information ab out side effects in long-term maintenance treatment would be of great clinical pertinence in ensuring safety and enhancing patients' quality of life.