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Anxiety psychopathology predictive of outcome in patients with panic disorder and depression treated with imipramine, alprazolam and placebo |
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| Authors: | Mark H Pollack Michael W Otto Gary S Sachs Andrew Leon M Katherine Shear Joseph A Deltito Martin B Keller Jerrold F Rosenbaum |
| Institution: | a Anxiety Disorders Program, Clinical Psychopharmacology Unit, Massachusetts General Hospital, Boston, MA 02114, USA b Department of Psychiatry, New York Hospital-Cornell Medical Center, New York, NY, USA c Anxiety Disorders Program, Western Psychiatric Institute, Pittsburgh, PA, USA d Anxiety and Mood Disorders Program, Cornell University Medical College- Westchester, NY, USA e Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA |
| Abstract: | This study examines clinical predictors of outcome for patients with panic disorder and depression in a 16 week, placebo-controlled trial of alprazolam and imipramine (n = 126). Baseline global severity of illness and phobic avoidance were differentially predictive of acute response to treatment. Patients in the mild to moderate range of global distress experienced smaller degrees of improvement on alprazolam than on imipramine at week 4. At endpoint, the relative effectiveness of the active medication versus placebo was diminished in patients with higher levels of phobic avoidance. This relationship was not evident for completers, suggesting that the adverse effects of avoidance on outcome after sustained treatment was reduced. |
| Keywords: | Panic disorder Depression Alprazolam Imipramine Placebo |
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