Double-Blind, Controlled, Crossover Trial of Inositol Versus Fluvoxamine for the Treatment of Panic Disorder

  title={Double-Blind, Controlled, Crossover Trial of Inositol Versus Fluvoxamine for the Treatment of Panic Disorder},
  author={Alex Palatnik and K Frolov and Mendel Fux and Jonathan Benjamin},
  journal={Journal of Clinical Psychopharmacology},
Only 70% of patients respond to current treatments for panic disorder, and many discontinue drugs because of side effects. myo-Inositol, a natural isomer of glucose and a precursor for the second-messenger phosphatidyl-inositol system, has previously been found superior to placebo in the treatment of depression, panic disorder, and obsessive-compulsive disorder (OCD), but a direct comparison with an established drug has never been performed. A double-blind, controlled, random-order crossover… 
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There was a trend for more subjects on inositol to show improvement in bipolar depression symptoms, but, on average, inposol was not more effective than placebo as an adjunct for bipolar depression.
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The importance of immediate and proper treatment, the gap in the current management of PD with special emphasis on pharmacotherapy, and evidence regarding the novel anti-panic drugs including the drugs in developments such as metabotropic glutamate (mGlu 2/3) agonist and levetiracetam are covered.
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Current pharmacological interventions in panic disorder.
Recent data indicate that augmentation strategies with aripiprazole, olanzapine, pindolol or clonazepam may be effective and D-cycloserine is a promising agent in the augmentation of cognitive behavioral therapy.
Treating Treatment-Resistant Patients with Panic Disorder and Agoraphobia Using Psychotherapy: A Randomized Controlled Switching Trial
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Pharmacologic Treatment of Panic Disorder
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Pharmacological treatment of panic disorder.
A comprehensive database has developed and precise recommendations can be provided for treating patients with panic disorder and combining drug treatment with cognitive behaviour therapy is the most successful treatment strategy for panic disorder.
Pharmacological Treatment with the Selective Serotonin Reuptake Inhibitors
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Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder.
Inositol's efficacy, the absence of significant side effects, and the fact that inositol is a natural component of the human diet make it a potentially attractive therapeutic for panic disorder.
Controlled trials of inositol in psychiatry
  • J. Levine
  • Psychology, Medicine
    European Neuropsychopharmacology
  • 1997
Double-blind, controlled trial of inositol treatment of depression.
This may be the first use of the precursor strategy for a second messenger rather than a neurotransmitter in treating depression, and inositol had a significant antidepressant effect in this study.
Imipramine treatment of panic disorder with agoraphobia: dose ranging and plasma level-response relationships.
The results provide strong evidence that imipramine has specific, clinically significant effects in this disorder, with practical implications for target doses and optimal plasma concentrations, and suggest that different mechanisms underlie the drug's antipanic and antiphobic effects.
A comparison of fluvoxamine, cognitive therapy, and placebo in the treatment of panic disorder.
Fluvoxamine was found to be an effective and well-tolerated treatment for panic using clinician- and patient-rated variables and cognitive therapy was not superior to fluvoxamine on any rating.
Efficacy and tolerability of serotonin transport inhibitors in obsessive-compulsive disorder. A meta-analysis.
While the results of this meta-analysis support the superiority of clomipramine, head-to-head, double-blind comparisons of these compounds would be the best test of comparative efficacy and tolerability.
Outcome of panic disorder with or without concomitant depression: A 2-year prospective follow-up study.
The data showed fluctuation of symptoms in both groups and a less favorable outcome for the patients with comorbid conditions, but the overall outcome was better than that reported in other studies and indicates that panic disorder is quite responsive to appropriate treatment.