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Venlafaxine, Paroxetine, Both Work on Panic: Presented at APA

By Roberta Friedman, PhD

SAN FRANCISCO, CA -- May 22, 2003 -- Panic attacks can be eased by treating patients with either the selective serotonin reuptake inhibitor (SSRI) paroxetine or the newer agent venlafaxine, which acts on both serotonin and noradrenaline.

Findings on the efficacy of paroxetine and venlafaxine in panic disorder were reported here on May 19^th at the 156^th Annual Meeting of the American Psychiatric Association.

Karen Tourian, MD, with Wyeth, said the 2 agents "for the most part, were equal" in their ability to treat panic in the study of 634 patients with Diagnostic and Statistical Manual Revision IV diagnosis of panic disorder with or without agoraphobia. Some patients had resisted prior treatment for their condition.

The study investigators, from Massachusetts General, Boston, Massachusetts, United States, tested doses of 75 and 150 mg a day of an extended-release formulation of venlafaxine and 40 mg a day of paroxetine to allow for European registration of the agent in this indication, Dr. Tourian explained.

About 100 women and 50 men in their 30s comprised each arm of the trial.

Dr. Tourian said venlafaxine onset of action appeared to be slightly faster, but the difference was not statistically significant.

More than half of patients given active drug treatment were panic-free by the end of the trial. By comparison, a third of placebo-treated patients were panic-free at the study end (P<0.001). More than 75% of all active drug recipients could be classified as responders, Dr. Tourian said.

Placebo comparisons showed that all drug treatments gave significantly lowered frequencies of panic attacks over the 12 weeks of treatment. Scores on the Panic Disorder Severity Scale also declined with each drug regimen compared with placebo.

This study will be part of several to show efficacy of their agent in panic disorder, Dr. Tourian said. Wyeth, which funded the study, has not yet submitted these data to the United States Food and Drug Administration, she added.

Panic can be treated with benzodiazepines, but these sedate and have addiction liability, she explained. Monoamine oxidase inhibitors also work for panic disorder but have problematic interactions with many foods. SSRIs "work pretty well" in panic, she said, "but are not as quick" as the other existing therapies.

Wyeth funded the work.


[Study title: Venlafaxine Extended Release and Paroxetine in the Short-Term Treatment of Panic Disorder. Abstract 204]

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