Serum levels of clomipramine and desmethylclomipramine and clinical improvement in panic disorder

Several placebo-controlled trials have shown the effcacy of clomipramine (CMI) in panic disorder. However, none has investigated the relationship between CMI, and desmethylclomipramine (DCMI) plasma levels, and outcome. In this trial, 41 patients meeting the DSM-III-R criteria for panic disorder wit...

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Bibliographic Details
Published in:Journal of psychopharmacology (Oxford) 1999, Vol.13 (1), p.40-44
Main Authors: Marcourakis, T., Gorenstein, C., Ramos, R. T., da Motta Singer, J.
Format: Article
Language:English
Subjects:
Adult
Antidepressive Agents, Tricyclic - blood
Antidepressive Agents, Tricyclic - therapeutic use
Anxiety
Biological and medical sciences
Clinical trials
Clomipramine
Clomipramine - analogs & derivatives
Clomipramine - blood
Clomipramine - therapeutic use
Female
Humans
Male
Medical sciences
Middle Aged
Neuropharmacology
Panic
Panic attacks
Panic Disorder - drug therapy
Panic Disorder - psychology
Pharmacology. Drug treatments
Plasma levels
Psychiatric Status Rating Scales
Psycholeptics: tranquillizer, neuroleptic
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Serum levels
Single-Blind Method
Variance analysis
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Summary:Several placebo-controlled trials have shown the effcacy of clomipramine (CMI) in panic disorder. However, none has investigated the relationship between CMI, and desmethylclomipramine (DCMI) plasma levels, and outcome. In this trial, 41 patients meeting the DSM-III-R criteria for panic disorder with/without agoraphobia received 50-200 mg of CMI daily in a single-blind, flexible dose regimen for 14 weeks. At the end of treatment, 97% of the patients were free of panic attacks. Patients were classified into two groups of improvement according to the panic symptom items of the `Patient-Rated Anxiety Scale'. A repeated-measures analysis of variance suggested a significant association between outcome and serum DCMI level/daily dose ratio as well as total serum level/daily dose. Patients with intense improvement showed DCMI and total serum levels lower than those with moderate improvement. The results indicate the importance of monitoring clomipramine and desmethylclomipramine serum levels in this disorder.
ISSN:0269-8811
1461-7285
DOI:10.1177/026988119901300105