[Panic disorder in general medicine. Epidemiological data and treatment with clomipramine]

Fifty-six general practitioners, experienced in the use of diagnostic criteria from DSM III for affective and anxiety disorders, have taken part in a study involving 352 patients, 92 males (26%) and 260 females (74%) with an average age of 38.6 +/- 13.5. The epidemiologic part of this work consists in a case-control comparison of socio-demographic characteristics among subjects with panic disturbance and others unaffected with it. It allows to conclude that panic disturbance is two times more frequent in women than in men and most often in young people. The results of the therapeutic with Clomipramine at low dosage (40 mg) objective a complete removal of panic attacks in 21.5% and 64% of patients after a respectively 15 days treatment. Other criteria of evaluation (Hamilton Depression Rating scale--HDRS), Montgomery and Asberg Depression Scale--MADRS--, clinician's global assessment) evolve favorably also. It is however interesting to note that though it is not in originally more depressed patients that panic disturbance is most improved by treatment, there is on the other hand a correlation between scores from MADRS and HDRS and the number of panic attacks under treatment. These results corroborate the hypothesis that Clomipramine can be effective at low dosage in some patients with panic disturbance--here, slightly less than 2/3 of the cases--while for other patients higher dosages are necessary.