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Open Access Highly Accessed Research article

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

James M Prosser1*, Samantha Yard2, Annie Steele1, Lisa J Cohen1 and Igor I Galynker1

Author Affiliations

1 The Department of Psychiatry and Behavioral Sciences, Beth Israel Medical Center, Albert Einstein College of Medicine, First Ave at 16th St, New York, NY 10003, USA

2 The Department of Psychology, University of Washington, Seattle, Washington, 98195, USA

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BMC Psychiatry 2009, 9:25  doi:10.1186/1471-244X-9-25

Published: 26 May 2009

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