Comparative effects of low and high doses of clomipramine and placebo in panic disorder: a double-blind controlled study

This study was designed to explore the dose-response relationship for clomi pramine in patients with panic disorder, with or without agoraphobia. After 1 week of single-blind placebo pretreatment, 180 such patients were assign ed to a multicentre placebo-controlled comparison of the effects of high an d low doses of clomipramine, and were followed up for 8 weeks. In alleviati ng anxiety and panic disorder, both clomipramine doses were more efficaciou s than placebo for panic disorder and, to a lesser degree, for phobia. The lower dose was better tolerated and at least as effective as the higher dos e, sometimes more so. These results indicate the clinically important possi bility that low-dose clomipramine is effective and well tolerated.