This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Ramos, R. T. Articles by Gorenstein, C. Search for Related Content PubMed Articles by Ramos, R. T. Articles by Gorenstein, C. Social Bookmarking                         What's this?

Clomipramine and initial worsening in panic disorder: beyond the 'jitteriness syndrome'

Instituto de Psiquiatria, Hospital das Clinicas, FMUSP

Valentim Gentil

LIM-23, Departamento de Psiquiatria, FMUSP

Clarice Gorenstein

Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Brazil

The time course and the phenomenology of the initial response to clomipramine (10-20 mg/day) was investigated in 70 patients with panic disorder with or without agoraphobia. Nineteen (27.1%) patients reported worsening of their clinical state which, on average, began 28 h after the first dose and lasted for 5 days. Increase in the frequency and severity of panic attacks was the most frequent finding (14 patients), followed by psycho- stimulant (jitteriness; n=9), depressive (n=8) and tonic anxiety symptoms (n=7). This pattern of initial worsening is different from the 'jitteriness syndrome' described for other antidepressants. Its implications for the understanding of the pathophysiology of panic disorder are discussed.

Key Words: panic • clomipramine • jitteriness • antidepressants • initial worsening

Journal of Psychopharmacology, Vol. 7, No. 3, 265-269 (1993)
DOI: 10.1177/026988119300700305


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				F. Lotufo-Neto, M. Bernik, R. T. Ramos, L. Andrade, C. Gorenstein, T. Cordas, M. Melo, and V. Gentil A dose-finding and discontinuation study of clomipramine in panic disorder J Psychopharmacol, January 1, 2001; 15(1): 13 - 17. [Abstract] [PDF]

				R. T. Ramos, L. G. Formigoni, J. C. Soares, F. N. Demetrio, S. R. C. Oliveira, and V. Gentil Dizziness predicts initial worsening in panic disorder: an otoneurological investigation J Psychopharmacol, January 1, 1996; 10(4): 313 - 316. [Abstract] [PDF]

				L. Dratcu, J. W. Keating, R. Sherwood, and M. Lader A comparison of augmenting central serotonin and noradrenaline function in healthy subjects: implications for studies on the neurochemistry of anxiety J Psychopharmacol, January 1, 1995; 9(2): 127 - 135. [Abstract] [PDF]