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Fluoxetine in panic disorder.

L Solyom1, C Solyom, B Ledwidge

  • 1University Hospital, Vancouver, British Columbia.

Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|June 1, 1991
PubMed
Summary
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Two patients with panic disorder, agoraphobia, and depression found fluoxetine effective. This selective serotonin reuptake inhibitor (SSRI) offered symptom relief without the significant weight gain associated with other antidepressants.

Area of Science:

  • Psychiatry
  • Pharmacology
  • Clinical Case Studies

Background:

  • Panic disorder with agoraphobia and depression are debilitating conditions often requiring multifaceted treatment approaches.
  • Treatment resistance and adverse effects, such as significant weight gain, can complicate management strategies for these disorders.
  • Selective serotonin reuptake inhibitors (SSRIs) are a common class of antidepressants used in managing these conditions.

Observation:

  • Two patients diagnosed with panic disorder with agoraphobia and comorbid depression were evaluated.
  • One patient was refractory to alprazolam, tricyclics, and behavioral therapy, experiencing relapse after discontinuing phenelzine due to 50 lbs weight gain.
  • The second patient, also diagnosed with post-traumatic stress disorder, showed no response to alprazolam, imipramine, or phenelzine, and gained 33 lbs on phenelzine.

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Findings:

  • Both patients demonstrated a positive therapeutic response to fluoxetine at a dosage of 80 mg per day.
  • Crucially, neither patient experienced significant weight gain while undergoing treatment with fluoxetine.
  • This suggests fluoxetine may be a viable alternative for patients experiencing treatment resistance and weight gain with other antidepressants.

Implications:

  • Fluoxetine may represent an effective treatment option for patients with panic disorder, agoraphobia, and depression who have not responded to other therapies or who experience problematic weight gain.
  • Further research into the efficacy and tolerability of higher-dose fluoxetine in treatment-resistant populations is warranted.
  • These case studies highlight the importance of considering individual patient responses and side effect profiles when selecting antidepressant pharmacotherapy.