Early coadministration of clonazepam with sertraline for panic disorder

Andrew W. Goddard, Thomas Brouette, Ahmad Almai, Praveen Jetty, Scott W. Woods, Dennis Charney

Research output: Contribution to journalArticle

128 Citations (Scopus)

Abstract

Background: There is debate about combining benzodiazepines with selective serotonin reuptake inhibitors in the acute treatment of panic disorder. Although this medication combination is widely used in clinical practice, there is no well-tested, optimal method of coadministering these medications for the treatment of panic disorder. The purpose of this study was to test the efficacy of early coadministration of clonazepam with sertraline in the treatment of panic disorder. Methods: Fifty patients with panic disorder were randomized into a double-blind clinical trial. Patients received open-label sertraline for 12 weeks (target dose, 100mg/d), and in addition were randomized to groups receiving either 0.5 mg of active clonazepam 3 times daily or placebo, clonazepam for the first 4 weeks of the trial. The clonazepam dose was then tapered during 3 weeks and discontinued. Results: Thirty-four (68%) of 50 patients completed the trial. Drop-out rates were similar in the sertraline/ placebo vs the sertraline/clonazepam group (38% vs 25%) (P=.5). An intent-to-treat analysis (on last observation carried forward data) revealed a much greater proportion of responders in the sertraline/clonazepam compared with the sertraline/placebo group at the end of week 1 of the trial (41% vs 4%) (P= .003). There was also a significant between-group difference at the end of week 3 with 14 (63%) of 22 of the sertraline/clonazepam group responding to treatment vs 8 (32%) of 25 of the sertraline/ placebo group (P=.05). This difference was not observed at other times during the trial. Conclusion: These data indicate that rapid stabilization of panic symptoms can be safely achieved with a sertraline/clonazepam combination, supporting the clinical utility of this type of regimen for facilitating early improvement of panic symptoms relative to sertraline alone.

Original languageEnglish (US)
Pages (from-to)681-686
Number of pages6
JournalArchives of General Psychiatry
Volume58
Issue number7
StatePublished - 2001
Externally publishedYes

Fingerprint

Clonazepam
Sertraline
Panic Disorder
Placebos
Panic
Serotonin Uptake Inhibitors
Therapeutics
Benzodiazepines
Observation
Clinical Trials

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Goddard, A. W., Brouette, T., Almai, A., Jetty, P., Woods, S. W., & Charney, D. (2001). Early coadministration of clonazepam with sertraline for panic disorder. Archives of General Psychiatry, 58(7), 681-686.

Early coadministration of clonazepam with sertraline for panic disorder. / Goddard, Andrew W.; Brouette, Thomas; Almai, Ahmad; Jetty, Praveen; Woods, Scott W.; Charney, Dennis.

In: Archives of General Psychiatry, Vol. 58, No. 7, 2001, p. 681-686.

Research output: Contribution to journalArticle

Goddard, AW, Brouette, T, Almai, A, Jetty, P, Woods, SW & Charney, D 2001, 'Early coadministration of clonazepam with sertraline for panic disorder', Archives of General Psychiatry, vol. 58, no. 7, pp. 681-686.
Goddard AW, Brouette T, Almai A, Jetty P, Woods SW, Charney D. Early coadministration of clonazepam with sertraline for panic disorder. Archives of General Psychiatry. 2001;58(7):681-686.
Goddard, Andrew W. ; Brouette, Thomas ; Almai, Ahmad ; Jetty, Praveen ; Woods, Scott W. ; Charney, Dennis. / Early coadministration of clonazepam with sertraline for panic disorder. In: Archives of General Psychiatry. 2001 ; Vol. 58, No. 7. pp. 681-686.
@article{26fd51fa78fb43b5825880a77d9a3bfc,
title = "Early coadministration of clonazepam with sertraline for panic disorder",
abstract = "Background: There is debate about combining benzodiazepines with selective serotonin reuptake inhibitors in the acute treatment of panic disorder. Although this medication combination is widely used in clinical practice, there is no well-tested, optimal method of coadministering these medications for the treatment of panic disorder. The purpose of this study was to test the efficacy of early coadministration of clonazepam with sertraline in the treatment of panic disorder. Methods: Fifty patients with panic disorder were randomized into a double-blind clinical trial. Patients received open-label sertraline for 12 weeks (target dose, 100mg/d), and in addition were randomized to groups receiving either 0.5 mg of active clonazepam 3 times daily or placebo, clonazepam for the first 4 weeks of the trial. The clonazepam dose was then tapered during 3 weeks and discontinued. Results: Thirty-four (68{\%}) of 50 patients completed the trial. Drop-out rates were similar in the sertraline/ placebo vs the sertraline/clonazepam group (38{\%} vs 25{\%}) (P=.5). An intent-to-treat analysis (on last observation carried forward data) revealed a much greater proportion of responders in the sertraline/clonazepam compared with the sertraline/placebo group at the end of week 1 of the trial (41{\%} vs 4{\%}) (P= .003). There was also a significant between-group difference at the end of week 3 with 14 (63{\%}) of 22 of the sertraline/clonazepam group responding to treatment vs 8 (32{\%}) of 25 of the sertraline/ placebo group (P=.05). This difference was not observed at other times during the trial. Conclusion: These data indicate that rapid stabilization of panic symptoms can be safely achieved with a sertraline/clonazepam combination, supporting the clinical utility of this type of regimen for facilitating early improvement of panic symptoms relative to sertraline alone.",
author = "Goddard, {Andrew W.} and Thomas Brouette and Ahmad Almai and Praveen Jetty and Woods, {Scott W.} and Dennis Charney",
year = "2001",
language = "English (US)",
volume = "58",
pages = "681--686",
journal = "JAMA Psychiatry",
issn = "2168-622X",
publisher = "American Medical Association",
number = "7",

}

TY - JOUR

T1 - Early coadministration of clonazepam with sertraline for panic disorder

AU - Goddard, Andrew W.

AU - Brouette, Thomas

AU - Almai, Ahmad

AU - Jetty, Praveen

AU - Woods, Scott W.

AU - Charney, Dennis

PY - 2001

Y1 - 2001

N2 - Background: There is debate about combining benzodiazepines with selective serotonin reuptake inhibitors in the acute treatment of panic disorder. Although this medication combination is widely used in clinical practice, there is no well-tested, optimal method of coadministering these medications for the treatment of panic disorder. The purpose of this study was to test the efficacy of early coadministration of clonazepam with sertraline in the treatment of panic disorder. Methods: Fifty patients with panic disorder were randomized into a double-blind clinical trial. Patients received open-label sertraline for 12 weeks (target dose, 100mg/d), and in addition were randomized to groups receiving either 0.5 mg of active clonazepam 3 times daily or placebo, clonazepam for the first 4 weeks of the trial. The clonazepam dose was then tapered during 3 weeks and discontinued. Results: Thirty-four (68%) of 50 patients completed the trial. Drop-out rates were similar in the sertraline/ placebo vs the sertraline/clonazepam group (38% vs 25%) (P=.5). An intent-to-treat analysis (on last observation carried forward data) revealed a much greater proportion of responders in the sertraline/clonazepam compared with the sertraline/placebo group at the end of week 1 of the trial (41% vs 4%) (P= .003). There was also a significant between-group difference at the end of week 3 with 14 (63%) of 22 of the sertraline/clonazepam group responding to treatment vs 8 (32%) of 25 of the sertraline/ placebo group (P=.05). This difference was not observed at other times during the trial. Conclusion: These data indicate that rapid stabilization of panic symptoms can be safely achieved with a sertraline/clonazepam combination, supporting the clinical utility of this type of regimen for facilitating early improvement of panic symptoms relative to sertraline alone.

AB - Background: There is debate about combining benzodiazepines with selective serotonin reuptake inhibitors in the acute treatment of panic disorder. Although this medication combination is widely used in clinical practice, there is no well-tested, optimal method of coadministering these medications for the treatment of panic disorder. The purpose of this study was to test the efficacy of early coadministration of clonazepam with sertraline in the treatment of panic disorder. Methods: Fifty patients with panic disorder were randomized into a double-blind clinical trial. Patients received open-label sertraline for 12 weeks (target dose, 100mg/d), and in addition were randomized to groups receiving either 0.5 mg of active clonazepam 3 times daily or placebo, clonazepam for the first 4 weeks of the trial. The clonazepam dose was then tapered during 3 weeks and discontinued. Results: Thirty-four (68%) of 50 patients completed the trial. Drop-out rates were similar in the sertraline/ placebo vs the sertraline/clonazepam group (38% vs 25%) (P=.5). An intent-to-treat analysis (on last observation carried forward data) revealed a much greater proportion of responders in the sertraline/clonazepam compared with the sertraline/placebo group at the end of week 1 of the trial (41% vs 4%) (P= .003). There was also a significant between-group difference at the end of week 3 with 14 (63%) of 22 of the sertraline/clonazepam group responding to treatment vs 8 (32%) of 25 of the sertraline/ placebo group (P=.05). This difference was not observed at other times during the trial. Conclusion: These data indicate that rapid stabilization of panic symptoms can be safely achieved with a sertraline/clonazepam combination, supporting the clinical utility of this type of regimen for facilitating early improvement of panic symptoms relative to sertraline alone.

UR - http://www.scopus.com/inward/record.url?scp=0034932506&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034932506&partnerID=8YFLogxK

M3 - Article

C2 - 11448376

AN - SCOPUS:0034932506

VL - 58

SP - 681

EP - 686

JO - JAMA Psychiatry

JF - JAMA Psychiatry

SN - 2168-622X

IS - 7

ER -