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Journal of Psychopharmacology
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Dizziness predicts initial worsening in panic disorder: an otoneurological investigation

Renato T. Ramos

Instituto de Psiquiatria, Hospital das Clinicas

Lázaro G. Formigoni

Departamento de Otorrinolaringologia

Jair C. Soares

Instituto de Psiquiatria, Hospital das Clinicas

Frederico N. Demetrio

Instituto de Psiquiatria, Hospital das Clinicas

Sergio R. C. Oliveira

Instituto de Psiquiatria, Hospital das Clinicas

Valentim Gentil

Instituto de Psiquiatria, Hospital das Clinicas, Departamento de Psiquiatria, Faculdade de Medicina Universidade de Sdo Paulo, Brazil

Dizziness is a frequent complaint during the initial worsening of panic patients treated with clomipramine. In order to investigate the relationship between dizziness and initial worsening mechanisms, otoneurological tests were administered to 32 consecutive patients with panic disorder, with or without agoraphobia, before treatment, 36 h after the first dose of 25 mg clomipramine and after treatment and full remission of the panic and agoraphobic symptoms. A pretreatment complaint of 'dizziness during panic attacks' but not the occurrence of otoneurological abnormalities, predicted the occurrence of clinical worsening at the start of treatment. A specific pattern of otoneurological abnormalities was not found, but only three patients had normal results in all three sessions. The inconsistent test results suggest that functional vestibular pathology is frequently associated with panic disorder.

Key Words: panic • dizziness • vestibular tests • clomipramine

Journal of Psychopharmacology, Vol. 10, No. 4, 313-316 (1996)
DOI: 10.1177/026988119601000410
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