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Long-term management of panic disorder
1Clinical Psychopharmacology Unit, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
The Journal of Clinical Psychiatry
|May 1, 1990
Summary
High-potency benzodiazepines like clonazepam and alprazolam show long-term effectiveness and safety for panic disorder. Many patients maintain positive responses without significant tolerance, offering an alternative to antidepressants.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Psychology
Background:
- High-potency benzodiazepines are effective for short-term panic disorder treatment.
- Long-term efficacy and safety require systematic investigation.
Purpose of the Study:
- To investigate the long-term efficacy and safety of high-potency benzodiazepines in panic disorder.
- To compare benzodiazepines with antidepressants for long-term panic disorder management.
Main Methods:
- Follow-up study of patients on clonazepam (1-year).
- Follow-up study of patients on alprazolam (2.5-year).
- Assessment of treatment response, tolerance, and discontinuation challenges.
Main Results:
- 90% of clonazepam patients maintained positive response without significant tolerance.
- Alprazolam therapy showed sustained therapeutic gains with little tolerance.
- Discontinuation may be easier with longer-acting benzodiazepines.
Conclusions:
- High-potency benzodiazepines are a viable long-term treatment for panic disorder.
- They offer an alternative to antidepressants, considering side effects and overdose risks.
- Further research is needed on combined behavioral and pharmacologic treatments.
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