A comparison of low-dose risperidone to paroxetine in the treatment of panic attacks: a randomized, single-blind study

James M Prosser, Samantha Yard, Annie Steele, Lisa J Cohen, Igor I Galynker, James M Prosser, Samantha Yard, Annie Steele, Lisa J Cohen, Igor I Galynker

Abstract

Background: Because a large proportion of patients with panic attacks receiving approved pharmacotherapy do not respond or respond poorly to medication, it is important to identify additional therapeutic strategies for the management of panic symptoms. This article describes a randomized, rater-blind study comparing low-dose risperidone to standard-of-care paroxetine for the treatment of panic attacks.

Methods: Fifty six subjects with a history of panic attacks were randomized to receive either risperidone or paroxetine. The subjects were then followed for eight weeks. Outcome measures included the Panic Disorder Severity Scale (PDSS), the Hamilton Anxiety Scale (Ham-A), the Hamilton Depression Rating Scale (Ham-D), the Sheehan Panic Anxiety Scale-Patient (SPAS-P), and the Clinical Global Impression scale (CGI).

Results: All subjects demonstrated a reduction in both the frequency and severity of panic attacks regardless of treatment received. Statistically significant improvements in rating scale scores for both groups were identified for the PDSS, the Ham-A, the Ham-D, and the CGI. There was no difference between treatment groups in the improvement in scores on the measures PDSS, Ham-A, Ham-D, and CGI. Post hoc tests suggest that subjects receiving risperidone may have a quicker clinical response than subjects receiving paroxetine.

Conclusion: We can identify no difference in the efficacy of paroxetine and low-dose risperidone in the treatment of panic attacks. Low-dose risperidone appears to be tolerated equally well as paroxetine. Low-dose risperidone may be an effective treatment for anxiety disorders in which panic attacks are a significant component.

Trial registration: ClinicalTrials.gov Identifier: NCT100457106.

Trial registration: ClinicalTrials.gov NCT00457106.

Figures

Figure 1
Figure 1
Survival by Group. Subject study attrition by treatment group.
Figure 2
Figure 2
CGI Scores Over Time. CGI scores at baseline and at termination by treatment group, as a percent of baseline score. Scores for subjects terminating study treatment prematurely were carried forward to V10.
Figure 3
Figure 3
PDS Scores Over Time for Risperidone and Paroxetine Treatment Groups. Scores over time for Total PDSS, PDSS Item 1, and PDSS Item 2 for two treatment groups, as a percent of baseline score. Scores for subjects terminating study treatment prematurely were carried forward to V10.
Figure 4
Figure 4
Ham-A, Ham-D, and SPASp Scores Over Time for risperidone and Paroxetine Treatment Groups. Scores over time for Total Ham-A, Total Ham-D, and Total SPASp for two treatment groups. Scores for subjects terminating study treatment prematurely were carried forward to V10.

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