THE EFFECT OF CITALOPRAM IN PANIC DISORDER

Background Citalopram is a serotonin reuptake inhibitor which has been demonstrated to be highly selective and with a superior tolerability profile to the classical tricyclic antidepressants. This study was des igned to test whether there was any difference in efficacy in the mana gement of panic disorder (PD) between citalopram and placebo. Method T his was a double-blind, placebo and clomipramine controlled, parallel group eight-week study. A total of 475 patients with PD, with or witho ut agoraphobia, were randomised to treatment with either placebo, clom ipramine 60 or 90 mg/day, or citalopram 10 or 15 mg/day, 20 or 30 mg/d ay, or 40 or 60 mg/day. Doses were increased over the first three week s, stabilised during the fourth week and fixed between weeks five and eight Results Treatment with citalopram at 20 or 30 mg, 40 or 60 mg an d clomipramine were significantly superior to placebo, judged by the n umber of patients free of panic attacks in the week prior to the final assessment. All rating scales examined suggested that citalopram 20 o r 30 mg was more effective than citalopram 40 or 60 mg. Conclusion The most advantageous benefit/risk ratio for the treatment of PD was asso ciated with citalopram 20 or 30 mg/day.