Produção Nacional
Revisado por pares
A Randomized, Naturalistic, Parallel-Group Study for the Long-Term Treatment of Panic Disorder With Clonazepam or Paroxetine
2011; Lippincott Williams & Wilkins; Volume: 32; Issue: 1 Linguagem: Inglês
10.1097/jcp.0b013e31823fe4bd
ISSN1533-712X
AutoresAntônio Egídio Nardi, Rafael C. Freire, Marina Dyskant Mochcovitch, R. Amrein, Michelle N. Levitan, Anna Lucia Spear King, Alexandre Martins Valença, André Barciela Veras, Flávia Paes, Aline Sardinha, Isabella Nascimento, Valfrido Leão de Melo Neto, Gisele Pereira Dias, Adriana Cardoso de O. e Silva, Gastão L. Soares‐Filho, Rafael Thomaz da Costa, Marco A. Mezzasalma, Marcele Regine de Carvalho, A.C. de Cerqueira, Jorge Hallak, José Alexandre S. Crippa, Márcio Versiani,
Tópico(s)Treatment of Major Depression
ResumoThis long-term extension of an 8-week randomized, naturalistic study in patients with panic disorder with or without agoraphobia compared the efficacy and safety of clonazepam (n = 47) and paroxetine (n = 37) over a 3-year total treatment duration. Target doses for all patients were 2 mg/d clonazepam and 40 mg/d paroxetine (both taken at bedtime). This study reports data from the long-term period (34 months), following the initial 8-week treatment phase. Thus, total treatment duration was 36 months. Patients with a good primary outcome during acute treatment continued monotherapy with clonazepam or paroxetine, but patients with partial primary treatment success were switched to the combination therapy. At initiation of the long-term study, the mean doses of clonazepam and paroxetine were 1.9 (SD, 0.30) and 38.4 (SD, 3.74) mg/d, respectively. These doses were maintained until month 36 (clonazepam 1.9 [SD, 0.29] mg/d and paroxetine 38.2 [SD, 3.87] mg/d). Long-term treatment with clonazepam led to a small but significantly better Clinical Global Impression (CGI)–Improvement rating than treatment with paroxetine (mean difference: CGI-Severity scale −3.48 vs −3.24, respectively, P = 0.02; CGI-Improvement scale 1.06 vs 1.11, respectively, P = 0.04). Both treatments similarly reduced the number of panic attacks and severity of anxiety. Patients treated with clonazepam had significantly fewer adverse events than those treated with paroxetine (28.9% vs 70.6%, P < 0.001). The efficacy of clonazepam and paroxetine for the treatment of panic disorder was maintained over the long-term course. There was a significant advantage with clonazepam over paroxetine with respect to the frequency and nature of adverse events.
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