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Title: Sertraline May Be Better Tolerated than Paroxetine in Panic Disorder: Presented at ADAA

"Sertraline May Be Better Tolerated than Paroxetine in Panic Disorder: Presented at ADAA"

By Thomas S. May TORONTO, ON -- March 30, 2003 -- Paroxetine and sertraline are equally effective in the treatment of panic disorder, but sertraline is better tolerated by most patients, according to a multinational, randomized, double-blind trial. "This was the first head-to-head comparison of these 2 [selective serotonin reuptake inhibitors] in panic disorder," said the study's lead author, Borwin Bandelow, MD, of the department of psychiatry, University of Goettingen, Germany. He presented the findings here March 29th at the 23rd Annual Conference of the Anxiety Disorders Association of America. To compare the efficacy and tolerability of sertraline and paroxetine in panic disorder, Dr. Bandelow and colleagues from Denmark, Switzerland, the Netherlands, and Turkey enrolled 225 outpatients with the disorder. They randomised 112 patients (mean age 39.6 years, 60% female) to sertraline 50-150 mg, and 113 (mean age 38.1 years, 66% female) to paroxetine titrated up to 40-60 mg. After the 12-week treatment period, the medication was gradually tapered over 3 weeks. Outcome measures included the Bandelow Panic and Agoraphobia Scale (PAS), panic attack frequency, and the Clinical Global Impression-Improvement (CGI-I) scale. An analysis of the results showed that both drugs performed equally well on all efficacy scales, Dr. Bandelow said. He noted, however, that there were some differences between the drugs regarding side effects and tolerability. Specifically, paroxetine was not as well tolerated as sertraline, with higher attrition due to adverse events (18% vs. 12%; P=0.258), and a higher proportion of patients reporting clinically significant (greater than 7%) weight gain (7% vs. <1%, P<0.05). Furthermore, tapering of paroxetine was associated with significant clinical worsening compared to sertraline. Namely, the percentage of patients who were free of panic attacks increased from 54% to 58% during sertraline taper but decreased from 53% to 42% during paroxetine taper (P<0.05). Pfizer Inc., manufacturers of sertraline (Zoloft), funded the study. [Study title: Sertraline vs. Paroxetine in the Treatment of Panic Disorder: A Multinational Randomized Double-Blind 15-Week Study. Abstract 71]

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