Sertraline treatment of panic disorder: results of a long-term study


Mark Hyman Rapaport MD, Psychopharmacology Research Program, Department of Psychiatry, University of California at San Diego and Psychiatric Service San Diego Veterans, Affairs Healthcare System, 8950 Villa La Jolla Dr., Suite 2243, La Jolla, CA 92037, USA


Objective: To investigate the long-term efficacy, prevention of relapse and safety of sertraline in the treatment of panic disorder.

Method: This study consisted of 52 weeks of open-label sertraline treatment (n=398) followed by a 28 weeks of a double-blind, placebo-controlled discontinuation trial (n=183).

Results: Ninety-three patients were randomized to sertraline and 90 were randomized to placebo. Discontinuation due to insufficient clinical response occurred in 23.6% of placebo-treated patients and 12.0% of sertraline-treated patients (log-rank test, P=0.040). Thirty-three per cent of placebo-treated patients had an exacerbation of panic symptomatology, versus 13% of sertraline-treated patients (log-rank test, P=0.005). Abrupt cessation of sertraline resulted in dizziness (4.3% sertraline vs. 16.9% placebo; P=0.007) and insomnia (4.3% sertraline vs. 15.7% placebo; P=0.013) occurring at significantly higher rates.

Conclusion: Long-term sertraline treatment was effective in preventing relapse of panic disorder, well tolerated and associated with minimal discontinuation symptoms.