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Original Research

Clomipramine Treatment of Panic Disorder: Pros and Cons

Laszlo A. Papp, Franklin R. Schneier, Abby J. Fyer, Michael R. Liebowitz, Jack M. Gorman, Jeremy D. Coplan, Raphael Campeas, Brian A. Fallon, and Donald F. Klein

Published: October 15, 1997

Article Abstract

Background: Controlled trials suggest that clomipramine may be a highly effective antipanic drug. Lowering the starting dose may alleviate troublesome initial side effects and increase acceptability and compliance.

Method: Fifty-eight patients with DSM-III-R panic disorder with or without agoraphobia underwent 13 weeks of clomipramine treatment. Starting at 10 mg/day, the dose was gradually increased to a mean dose of 97 mg/day.

Results: While completers showed highly significant improvement, the benefits were severely limited by a high dropout rate due to adverse reactions occurring mostly during the first 2 weeks of treatment.

Conclusion: Given the alternatives, clomipramine should not be used as a first-line antipanic medication.

Volume: 58

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