Am J Psychiatry 1992; 149:1053-1057
Copyright © 1992 by American Psychiatric Association
Protective effects of imipramine maintenance treatment in panic disorder with agoraphobia
M Mavissakalian and JM Perel
Department of Psychiatry, Ohio State University College of Medicine, Columbus.
OBJECTIVE: This study was designed to assess and compare the differential
relapse rates of patients with panic disorder and agoraphobia after
discontinuation of acute treatment (6 months) or acute plus maintenance
treatment (18 months) with imipramine. METHOD: Sixteen patients with panic
disorder and agoraphobia who had shown marked and stable response to 6
months of acute imipramine treatment and a comparable group of 14 patients
who had been in remission during an additional year of half-dose imipramine
maintenance treatment entered a 3-month, double-blind discontinuation study
followed by a 3- month drug-free period. Assessments of the patients were
made according to operationalized response/relapse criteria, and plasma
drug concentrations were monitored. RESULTS: Survival analysis revealed
significantly different cumulative probabilities of continued response 6
months after discontinuation of imipramine treatment between the patients
who had received only acute treatment and those who had received acute and
maintenance treatment. CONCLUSIONS: The results support the hypothesis that
successful imipramine maintenance treatment of patients with panic and
agoraphobia can have protective effects against relapse, at least in the
first 6 months after the maintenance treatment period.
