Re: Experimental affective symptoms in panic disorder patients.
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Comorbidity↗
Biomedical subjects
Antonio Egidio Nardi
Publications and source records attributed to Antonio Egidio Nardi.
Therapeutic response to benzodiazepine in panic disorder subtypes.
CONTEXT: This study makes a comparison between two subtypes of panic disorder regarding the clinical efficacy of clonazepam, a benzodiazepine. OBJECTIVES: To evaluate the clinical efficacy of clonazepam in a fixed dosage (2 mg/day), compared to placebo, in the treatment of panic disorder patients and to verify whether there are any differences in the responses to clonazepam between panic disorder patients with the respiratory and non-respiratory subtypes. TYPE OF STUDY: Randomized study with clonazepam and placebo. SETTING: Outpatient Anxiety and Depression Unit of the Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. PARTICIPANTS: 34 patients with a diagnosis of panic disorder with agoraphobia, between 18 and 55 years old. PROCEDURES: Administration of clonazepam or placebo for 6 weeks, in panic disorder patients, after they were classified within two subtypes of panic disorder: respiratory and non-respiratory. MAIN MEASUREMENTS: Changes in the number of panic attacks in comparison with the period before the beginning of the study; Hamilton Anxiety Scale; Global Clinical Impression Scale; and Patient's Global Impression scale. RESULTS: In the group that received clonazepam, by the end of the 6th week there was a statistically significant clinical improvement, shown by the remission of panic attacks (p < 0.001) and decrease in anxiety (p = 0.024). In the group that received clonazepam there was no significant difference between the respiratory and non-respiratory subtypes of panic disorder, regarding the therapeutic response to clonazepam. CONCLUSION: Clonazepam was equally effective in the treatment of the respiratory and non-respiratory subtypes of panic disorder, suggesting there is no difference in the therapeutic response between the two subtypes.
Adolescent↗
Psychiatric disorders in asthmatic outpatients.
It has been reported that the lifetime prevalence of panic disorder in patients with pulmonary disease is higher than epidemiologic estimates of population prevalence. We evaluated the frequency of anxiety disorders in 86 subjects from the Outpatient Asthma Clinic. Psychiatric diagnoses were assessed with the Mini-International Neuropsychiatric Interview 4.4 Version (MINI). Forty-five asthmatic patients (52.3%) reported at least one current anxiety disorder. The frequency of panic disorder with or without agoraphobia was 13.9% (n=12) and that of agoraphobia without panic disorder was 26.8% (n=23). Social anxiety and generalized anxiety disorders occurred in 9.3% (n=8) and 24.4% (n=21) of the sample, respectively. Twenty-nine patients (33.7%) reported a major depressive episode. The psychiatric morbidity of the sample was 61.6% (n=53). Our results tend to support the high morbidity of anxiety disorders, particularly panic/agoraphobic spectrum disorders, in asthmatic outpatients.
Adolescent↗
Panic disorder and obsessive compulsive disorder in a hyperventilation challenge test.
BACKGROUND: Stress-induced hyperventilation produces symptoms that people are prone to misinterpret as life-threatening if they are unaware of the consequences of overbreathing. Our aim was to observe the induction of panic attacks by a hyperventilation challenge test in a series of panic disorder and obsessive compulsive disorder (OCD) patients (DSM-IV). METHOD: We randomly selected 28 panic disorder patients, 21 OCD patients and 28 normal volunteers. All patients were drug free for a week. They were induced to hyperventilate (30 breaths/min) for 4 min. Anxiety scales were applied before and after the test. RESULTS: A total of 64.3% (n=18) panic disorder patients, 9.5% (n=2) OCD patients and 3.6% (n=1) of control subjects had a panic attack after hyperventilating (chi(2)=3.99, d.f.=2, P=0.026). LIMITATIONS: The hyperventilation challenge test has a low sensitivity for panic disorder. CONCLUSION: In this challenge test the panic disorder patients were more sensitive to hyperventilation than OCD patients and normal volunteers. The induction of panic attacks by voluntary hyperventilation may be an easy test for validating the diagnosis in certain panic disorder patients.
Adult↗
Carbon dioxide test as an additional clinical measure of treatment response in panic disorder.
OBJECTIVE: We aim to determine if a treatment with a dose of clonazepam--2 mg/day, for 6 weeks, blocks spontaneous panic attacks and the ones induced by the inhalation of 35% carbon dioxide (CO2) in panic disorder (PD) patients. The CO2 challenge-test may be a useful addition tool for measuring the pharmacological response during the initial phase (6 weeks) in the treatment of PD. METHOD: Eighteen PD patients drug free for a week participated in a carbon dioxide challenge test. Fourteen had a panic attack and were openly treated for a 6-week period with clonazepam. At the end of the 6-week period they were submitted again to the CO2 challenge test. RESULTS: After 6 weeks of treatment with clonazepam, 12 of 14 PD patients (85.7%) did not have a panic attack after the CO2 challenge test. Just 2 of 14 patients (14.3%) had a panic attack after the CO2 challenge test. Ten of 14 (71.4%) PD patients had panic free status after clonazepam treatment. The 2 patients who had a panic attack in the sixth week, after the CO2 test, did not have panic free status after the treatment with clonazepam. CONCLUSION: The CO2-test may be a valid tool for testing and predicting the drug response.
Administration, Inhalation↗