The effect of mirtazapine in panic disorder: an open label pilot study with a single-blind placebo run-in period

In this open label pilot study, we studied the efficacy of mirtazapine (Rem eron) in panic disorder. Twenty-eight patients with a DSM-IV diagnosis of p anic disorder, with or without agoraphobia (10 males/18 females), were incl uded and 19 patients completed the study. The 15-week trial started with a 3-week single-blind placebo run-in period. After this run-in period, the 12 -week active treatment phase started. As primary efficacy measures, we stud ied the decrease in the number of full symptom panic attacks and the number of patients completely free of panic during the last 3 weeks of the study. Seventy-four percent of the patients were considered responders, according to a decrease of at least 50% in panic attack frequency. All primary and s econdary efficacy measures showed a significant improvement from the second week of active treatment onwards to endpoint. The main side-effects were d ifferent from the usual side-effects in selective serotonin reuptake inhibi tors (SSRIs) (initial drowsiness, weight gain and pain in the legs). The re sults of this open label study in panic disorder suggest that mirtazapine s eems to be a fast and effective treatment alternative for SSRIs in panic di sorder. (C) 2001 Lippincott Williams & Wilkins.