Paroxetine in child and adolescent outpatients with panic disorder

Paroxetine has repeatedly been shown to be effective in the treatment of pa nic disorder (PD) in adults, and, according to previous case observations, it may be useful in treating children and adolescents with PD as well. This preliminary naturalistic study examines effectiveness and safety of paroxe tine in the treatment of children and adolescents with PD. A chart review w as conducted on 18 patients with Diagnostic and Statistical Manual of Menta l Disorders PD admitted to the Division of Child Neurology and Psychiatry a nd to the Department of Psychiatry at the University of Pisa. Paroxetine wa s given at an initial mean dosage of 8.9 +/- 2.1 mg/day and was gradually i ncreased up to 40 mg/day, depending on clinical response and side effects. Clinical status was assessed with the Clinical Global Impression (CGI) and adverse effects were assessed retrospectively at each visit. Patients with final CGI-Improvement scores of 1 or 2 were considered responders. Mean par oxetine treatment duration was 11.7 +/- 8.3 months, with a mean final dosag e of 23.9 +/- 9.8 mg/day (range, 10-40 mg/day). No patient had to interrupt the treatment because of side effects. Fifteen patients (83.3%) were consi dered responders. The mean change on the CGI-Severity scale was statistical ly significant (p<0.0001). Paroxetine was well tolerated and effective in t he treatment of PD in these children and adolescents.