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Pattern of placebo response in panic disorder
M K Shear1, A C Leon, M H Pollack
1Department of Psychiatry, University of Pittsburgh, PA 15213, USA.
Psychopharmacology Bulletin
|January 1, 1995
Summary
In depressed patients with panic disorder, placebo responders were more severely ill than those on medication. This highlights the need to assess all panic disorder symptoms for treatment efficacy.
Area of Science:
- Psychiatry
- Clinical Psychology
- Pharmacology
Background:
- Panic disorder often co-occurs with depression, complicating treatment.
- Placebo response is a significant factor in clinical trials for psychiatric disorders.
- Understanding placebo effects is crucial for interpreting treatment efficacy.
Purpose of the Study:
- To characterize placebo response patterns in patients with comorbid depression and panic disorder.
- To compare placebo responders with active medication responders and non-responders.
- To evaluate the impact of placebo effects on treatment outcome measures.
Main Methods:
- Randomized clinical trial comparing imipramine, alprazolam, and placebo.
- Inclusion criteria: panic disorder and a concurrent depressive diagnosis.
- Assessment of panic attack remission and other clinical measures at Week 8.
Main Results:
- 16 out of 28 placebo-treated patients achieved panic remission.
- Placebo remitters were significantly more ill on baseline measures than active medication remitters.
- Placebo remitters did not differ from active medication non-remitters on other clinical measures.
Conclusions:
- Placebo response in panic disorder with depression is complex.
- Assessing only panic remission may overestimate treatment efficacy.
- Comprehensive symptom assessment is necessary to accurately determine treatment effectiveness.