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The British Journal of Psychiatry (2001) 179: 514-518
© 2001 The Royal College of Psychiatrists

Efficacy of usual antidepressant dosing regimens of fluoxetine in panic disorder

Randomised, placebo-controlled trial

DAVID MICHELSON, MD

CHRISTER ALLGULANDER, MD, KARL DANTENDORFER, MD, ALEKSANDAR KNEZEVIC, MD, DAGMAR MAIERHOFER, MD, VITOMIR MICEV, MD, VLADIMIR R. PAUNOVIC, MD, IVANA TIMOTIJEVIC, MD, NEENA SARKAR, PhD, LENNART SKOGLUND, MD and S. CRAIG PEMBERTON

Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana, USA

Correspondence: Dr David Michelson, Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Drop Code 6026, Indianapolis, IN 46285, USA. Tel: (317) 277 6443; fax: (317) 277 3262

Declaration of interest This study was funded by Eli Lilly and Company. Drs Michelson and Sarkar and Mr Pemberton are employees of Eli Lilly and Company. Drs Allgulander, Dantendorfer, Knezevic, Maierhofer, Micev, Paunovic, Timotijevic and Skoglund are paid consultans to Eli Lilly and Company.

Background Although serotonin reuptake inhibitors are effective in panic disorder, questions concerning whether doses associated with antidepressant efficacy are also effective for panic disorder remain.

Aims To assess the efficacy of the usual antidepressant dose of fluoxetine in treating full panic attacks.

Method Patients with panic disorder were randomised to placebo or to fluoxetine initiated at 10 mg daily for 1 week and then increased to 20 mg daily. The trial lasted 12 weeks, but after 6 weeks patients who had failed to achieve a satisfactory response were eligible for dose escalation to a maximum of 60 mg of fluoxetine daily.

Results Fluoxetine was associated with a statistically significantly greater proportion of panic-free patients compared with placebo after 6 weeks and at end-point.

Conclusions Fluoxetine at a dose of 20 mg daily is safe and efficacious in reducing symptoms of panic disorder. Patients who fail to obtain a satisfactory response at 20 mg daily may benefit from further dose increases.


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