Some antidepressants have proved effective for panic disorder, but patients beginning treatment should be warned that these agents can have a paradoxical effect, Dr. Eric M. Reiman said at a psychopharmacology conference sponsored by the University of Arizona.
These agents can cause an increase in agitation along with a transient increase in the frequency and duration of panic attacks.
Dr. Reiman of the University of Arizona, Phoenix, warned, "If you do not tell them about this paradoxical activating effect, you will not see [them] again if they get it."
Seven antidepressants have proven efficacy in panic disorder: paroxetine, sertraline, fluoxetine, citalopram, fluvoxamine, imipramine, and clomipramine. Three antidepressants have proved to be ineffective: amoxapine, trazodone, and bupropion.
Paroxetine and sertraline seem to induce less of the paradoxical effect in patients with panic disorder, according to the results of multicenter trials.
To minimize the paradoxical activating effect, Dr. Reiman recommended starting patients on an unusually low dose and increasing the dose slowly.
COPYRIGHT 2002 International Medical News Group
COPYRIGHT 2002 Gale Group
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