Pharmacological and Neuromodulatory Treatments for Panic Disorder: Clinical Trials from 2010 to 2018
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Objective Treatment for panic disorder (PD) have evolved, although there is still a strong unmet need for more effective and tolerable options. The present study summarizes and discusses recent evidence regarding the pharmacological and neuromodulatory treatment of PD. Methods MEDLINE, Cochrane Library, PsycINFO and Thomson Reuters’s Web of Science were searched for clinical trials published between 2010 and 2018. We included all prospective experimental studies including randomized controlled trials (RCT) and other clinical trials with more than 10 patients. Results Only 11 articles met the inclusion criteria, including 4 RCT, 3 open clinical trials and 5 comparative clinical trials. RCT demonstrated efficacy of transcranial magnetic stimulation (TMS) in only one of two trials. Neither pindolol nor d-fenfluramine were effective in blocking flumazenil-induced panic attacks. Augmentation with quetiapine was not superior to placebo. Open trials indicated that escitalopram, vortioxetine and TMS may be effective. Comparative trials did not demonstrate superiority from any drug, but confirmed tranylcypromine, paroxetine, clonazepam and alprazolam as effective options. Conclusion The current study confirmed the efficacy of tranylcypromine, paroxetine, clonazepam, alprazolam and escitalopram. Vortioxetine and TMS, with duration of 4 or more weeks, also seems to be effective. Quetiapine, pindolol and d-fenfluramine were not considered effective compounds.
Abstract
Objective Treatment for panic disorder (PD) have evolved, although there is still a strong unmet need for more effective and tolerable options. The present study summarizes and discusses recent evidence regarding the pharmacological and neuromodulatory treatment of PD. Methods MEDLINE, Cochrane Library, PsycINFO and Thomson Reuters’s Web of Science were searched for clinical trials published between 2010 and 2018. We included all prospective experimental studies including randomized controlled trials (RCT) and other clinical trials with more than 10 patients. Results Only 11 articles met the inclusion criteria, including 4 RCT, 3 open clinical trials and 5 comparative clinical trials. RCT demonstrated efficacy of transcranial magnetic stimulation (TMS) in only one of two trials. Neither pindolol nor d-fenfluramine were effective in blocking flumazenil-induced panic attacks. Augmentation with quetiapine was not superior to placebo. Open trials indicated that escitalopram, vortioxetine and TMS may be effective. Comparative trials did not demonstrate superiority from any drug, but confirmed tranylcypromine, paroxetine, clonazepam and alprazolam as effective options. Conclusion The current study confirmed the efficacy of tranylcypromine, paroxetine, clonazepam, alprazolam and escitalopram. Vortioxetine and TMS, with duration of 4 or more weeks, also seems to be effective. Quetiapine, pindolol and d-fenfluramine were not considered effective compounds.
참고문헌 (36)
- Asmundson GJ, "Panic disorder and agoraphobia : an overview and commentary on DSM-5 changes", Depress Anxiety, 31, pp.480~486 (2014)
- "Treatment of patients with panic disorder 2009"[URL]
- Perna G, "Novel investigational therapeutics for panic disorder", Expert Opin Investig Drugs, 24, pp.491~505 (2015)
- Bandelow B, "Pharmacological treatment of panic disorder", Mod Trends Pharmacopsychiatry, 29, pp.128~143 (2013)
- Freire RC, "Treatment-resistant panic disorder : a systematic review", Expert Opin Pharmacother, 17, pp.159~168 (2016)
- Perna G, "Emerging drugs for panic disorder", Expert Opin Emerg Drugs, 16, pp.631~645 (2011)
- Freire RC, "New treatment options for panic disorder : clinical trials from 2000 to 2010", Expert Opin Pharmacother, 12, pp.1419~1428 (2011)
- Freire RC, "Update on pharmacological treatment of panic disorder", Minerva Psichiatrica, 52, pp.145~155 (2011)
- Boutros NN, "Anticonvulsant medications for panic disorder : A review and synthesis of the evidence", Int J Psychiatry Clin Pract, 18, pp.2~10 (2014)
- Deppermann S, "Does rTMS Alter Neurocognitive Functioning in Patients with Panic Disorder", Agoraphobia? An fNIRS-Based Investigation of Prefrontal Activation during a Cognitive Task and Its Modulation via Sham-Controlled rTMS, 2014, pp.2014, 542526~
- Li H, "Repetitive transcranial magnetic stimulation (rTMS) for panic disorder in adults", Cochrane Database Syst Rev, (9), pp.CD009083~ (2014)
- Bernik M, "Effect of single doses of pindolol and d-fenfluramine on flumazenil-induced anxiety in panic disorder patients", Behav Brain Res, 357-358, pp.82~87 (2019)
- Deppermann S, "Neurobiological and clinical effects of fNIRS-controlled rTMS in patients with panic disorder", agoraphobia during cognitivebehavioural therapy, 2017, pp.16, 668~677
- Goddard AW, "A controlled trial of quetiapine XR coadministration treatment of SSRI-resistant panic disorder", Ann Gen Psychiatry, 14, pp.26~ (2015)
- Mantovani A, "Randomized sham controlled trial of repetitive transcranial magnetic stimulation to the dorsolateral prefrontal cortex for the treatment of panic disorder with comorbid major depression", J Affect Disord, 144, pp.153~159 (2013)
- Kwan-Woo Choi, "Long-term Escitalopram Treatment in Korean Patients with Panic Disorder: A Prospective, Naturalistic, Open-label, Multicenter Trial", Clinical Psychopharmacology and Neuroscience, 10(1), pp.44~48 (2012), 대한정신약물학회[DOI]
- Shah A, "An open-label, flexible dose adaptive study evaluating the efficacy of vortioxetine in subjects with panic disorder", Ann Gen Psychiatry, 17, pp.19~ (2018)
- Buoli M, "Slow vs standard up-titration of paroxetine in the treatment of panic disorder : a prospective randomized trial", Psychiatry Clin Neurosci, 64, pp.612~619 (2010)
- Marquez M, "Efficacy of alprazolam sublingual tablets in the treatment of the acute phase of panic disorders", Actas Esp Psiquiatr, 39, pp.88~94 (2011)
- Nardi A, "Double-blind comparison of 30 and 60 mg tranylcypromine daily in patients with panic disorder comorbid with social anxiety disorder", Psychiatry Res, 175, pp.260~265 (2010)
- Nardi A, "Psychopharmacotherapy of panic disorder : 8-week randomized trial with clonazepam and paroxetine", Braz J Med Biol Res, 44, pp.366~373 (2011)
- Nardi A, "A randomized, naturalistic, parallel-group study for the long-term treatment of panic disorder with clonazepam or paroxetine", J Clin Psychopharmacol, 32, pp.120~126 (2012)
- Goddard A, "A controlled trial of quetiapine XR coadministration treatment of SSRI-resistant panic disorder", Ann Gen Psychiatry, 14, pp.26~ (2015)
- Prasko J, "The effect of repetitive transcranial magnetic stimulation(rTMS)add on serotonin reuptake inhibitors in patients with panic disorder : a randomized, double blind sham controlled study", Neuro Endocrinol Lett, 28, pp.33~38 (2007)
- Freire RC, "Current pharmacological interventions in panic disorder", CNS Neurol Disord Drug Targets, 13, pp.1057~1065 (2014)
- Freire RC, "A 6-year posttreatment follow-up of panic disorder patients : treatment with clonazepam predicts lower recurrence than treatment with paroxetine", J Clin Psychopharmacol, 37, pp.429~434 (2017)
- piperazine(Lu AA21004) : a novel multimodal compound for the treatment of major depressive disorder, "J Med Chem", 2011, 3206~3221
- Sanchez C, "Vortioxetine, a novel antidepressant with multimodal activity : review of preclinical and clinical data", Pharmacol Ther, 145, pp.43~57 (2015)
- Connolly KR, "Vortioxetine : a new treatment for major depressive disorder", Expert Opin Pharmacother, 17, pp.421~431 (2016)
- Guaiana G, "Antidepressants and benzodiazepines for panic disorder in adults", Cochrane Database Syst Rev, 9, pp.CD011567~ (2016)
- Moylan S, "The efficacy and safety of alprazolam versus other benzodiazepines in the treatment of panic disorder", J Clin Psychopharmacol, 31, pp.647~652 (2011)
- Merideth C, "Efficacy and tolerability of extended release quetiapine fumarate monotherapy in the acute treatment of generalized anxiety disorder : a randomized, placebo controlled and active-controlled study", Int Clin Psychopharmacol, 27, pp.40~54 (2012)
- Bandelow B, "Extended-release quetiapine fumarate (quetiapine XR): a once-daily monotherapy effective in generalized anxiety disorder. Data from a randomized, double-blind, placebo- and active-controlled study", Int J Neuropsychopharmacol, 13, pp.305~320 (2010)
- Prosser JM, "A comparison of low-dose risperidone to paroxetine in the treatment of panic attacks : a randomized, single-blind study", BMC Psychiatry, 9, pp.25~ (2009)
- Sepede G, "Olanzapine augmentation in treatment-resistant panic disorder : a 12-week, fixed-dose, open-label trial", J Clin Psychopharmacol, 26, pp.45~49 (2006)
- Hoge EA, "Aripiprazole as augmentation treatment of refractory generalized anxiety disorder and panic disorder", CNS Spectr, 13, pp.522~527 (2008)
