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Placebo response in panic disorder. A review

Published online by Cambridge University Press:  16 April 2020

WA Merz*
Affiliation:
F Hoffmann-La Roche AG, Department of Clinical Research, PO Box, CH-4002Basel, Switzerland
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Summary

A short review of placebo response in double-blind placebo-controlled therapeutic panic disorder studies published since 1985 is given. The main result is that the inefficacy-related drop-out rate of the placebo group of almost all clinical studies grows to more than 30% after 4-5 weeks of treatment and that often the results of placebo responders do not widely differ from that of the treatment groups. Except in some studies with very large sample sizes, the described response of the placebo group will not lead to significant differences between placebo and drug in completer analysis, making last observation carried forward (LOCF) analysis necessary. However, the large drop-out rates may lead to invalid efficacy results in later stages of the studies. As it can be shown that the inefficacy-related drop-out rates between placebo and target drug groups are as good an efficacy characteristic as any other, more conventional efficacy parameters, it is proposed to use the inefficacy related drop-out rate as the main efficacy parameter in placebo-controlled panic disorder studies of more than 4-5 weeks.

Type
Review Article
Copyright
Copyright © Elsevier, Paris 1994

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References

Ballenger, JCBurrows, GDDuPont, RIet al. Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. Arch Gen Psychiatry 1989:45:413–22CrossRefGoogle Scholar
Black, DWWesner, RBowers, WGabel, JA comparison of fluvoxamine, cognitive therapy and placebo in the treatment of panic disorder. Arch Gen Psychiatry 1993:50:4450CrossRefGoogle ScholarPubMed
Cross-National Collaborative Panic Study, Second Phase Investigators. Drug treatment of panic disorder. Comparative efficacy of alprazolam, imipramine and placebo, Br J Psychiatry 1992:160: 191–02CrossRefGoogle Scholar
Evans, LKennedy, JSchneider, PHoey, HEffect of a selective serotonin uptake inhibitor in agoraphobia with panic attacks. A double-blind comparison of zimeldine, imipramine and placebo. Acta Psychiatr Scand 1986:73:4953CrossRefGoogle ScholarPubMed
Fahy, TJO'Rourke, DBrophy, JSchazman, WSciasela, SThe Galway Study of panic disorder I: clomipramine and lofepiamine in DSM III-R panic disorder: a placebo controlled trial. J Affective Disord 1992:25:6370CrossRefGoogle ScholarPubMed
Katschnig, HMerz, WABerger, PNutzinger, DAlf, CKutzer, MAmering, MAttack-related treatment of panic disorder with bretazenil – A randomized placebo-controlled clinical trial. In: Racagni, GBrunello, NFukuda, Τ eds. Biological Psychiatry. Amsterdam: Elsevier, 1991:1:7135Google Scholar
Leber, P Policy for the review of efficacy of NDAS by FDAS. Division of neuropharmacological drug product. 1986; Doc #3697pGoogle Scholar
Lydiard, RBLesser, IMBallenger, JCRubin, RTLaraia, MDuPont, RA fixed-dose study of alprazolam 2 mg, alprazolam 6 mg and placebo in panic disorder. J Clin Psychopharmacol 1992;12:96103CrossRefGoogle ScholarPubMed
Merz, WAAmrein, RNeumann, NStettler, Vvon Planta, ΤMontanari, CBretazenil prn in Panic Disorder. Research report B-113'562, F Hoffmann-La Roche Ltd, Basel, 1993Google Scholar
Modigh, KWestberg, PEriksson, ESuperiority of clomipramine over imipramine in the treatment of panic disorder: a placebo-controlled trial. J Clin Psychopharmacol 1993;12:251–61Google Scholar
Munjack, DJCrocker, BCabe, Det al. Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks. J clin Psychopharmacol 1989:9:22–7CrossRefGoogle ScholarPubMed
Savoldi, FSomenzini, GEcari, UEtizolam versus placebo in the treatment of panic disorder with agoraphobia: a double-blind study. Curr Med Res Opinion 1990; 12:185–90CrossRefGoogle ScholarPubMed
Schweizer, ERickels, KWeiss, SZavodnick, SMaintenance drug treatment of panic disorder. I. Results of a prospective, placebo-controlled comparison of alprazolam and imipramine. Arch Gen Psychiatry 1993:50:5160CrossRefGoogle ScholarPubMed
Taylor, CBHayward, CKing, Ret al. Cardiovascular and symptomatic reduction. Effects of alprazolam and imipramine in patients with panic disorder: results of a double-blind, placebo-controlled trial. J Clin Psychopharmacol 1990:10:112–8CrossRefGoogle ScholarPubMed
Tesar, GERosenbaum, JFPollack, MHet al. Double-blind, placebo-controlled comparison of clonazepam and alprazolam for panic disorder. J clin Psychiatry 1991:52:6976Google ScholarPubMed
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