GAUGING THE EFFECTIVENESS OF EXTENDED IMIPRAMINE TREATMENT FOR PANIC DISORDER WITH AGORAPHOBIA

Background: Imipramine has proven efficacy for panic disorder. This st ructure assesses the net effectiveness of systematic, open imipramine treatment in a homogenous sample of panic disorder patients with agora phobia. Methods: One hundred and ten consecutive patients with DSM-III -R moderate to severe panic disorder with agoraphobia were treated wit h a fixed regimen of imipramine 2.25 mg/kg/day, for 24 weeks. No instr uctions or encouragement for self-directed exposure to phobic situatio ns or other coping strategies with panic or fear were given. Assessmen ts were conducted at the end of the 2-week placebo run-in and at weeks 8, 16, and 24 of treatment. Results: Overall, 53% had a marked and st able response. Most measures revealed that substantial improvement con tinued beyond week 8 of treatment. Treatment success was accompanied w ith significant improvements in anxiety sensitivity, dysphoric mood, a nd functional well-being. Conclusions: These results provide a clinica lly relevant reference with which to compare the effectiveness of alte rnative treatments in providing nearly complete symptom remission in p atients with primary panic disorder with agoraphobia. (C) 1998 Society of Biological Psychiatry.