Biomedical subjects
Publications and source records attributed to S Soto.
Buspirone was compared with imipramine and placebo in the treatment of panic disorder in an 8-week, double-blind controlled study of 52 randomly assigned patients. The side effect profile of buspirone was less disruptive than that of imipramine. Buspirone was not significantly superior to placebo in its antipanic or anxiolytic effects in panic disorder patients.
There is a need for safe effective alternatives to benzodiazepines in the treatment of panic disorder. Buspirone, a new nonbenzodiazepine anxiolytic, is compared to imipramine and placebo in the treatment of panic disorder in an 8 week double-blind controlled study of 52 randomly assigned patients. Weekly assessments were made using the Hamilton Anxiety Scale, the Sheehan Clinician Rated Anxiety Scale, the Sheehan Patient Rated Anxiety Scale, the Phobia Scale, the Disability Scale, the Hamilton Depression Scale, the Montgomery Asberg Depression Scale, the Investigator Rated Global Improvement Scale and the Patient Rated Global Improvement Scale. Preliminary results of repeated measures Anovas are reported. Imipramine was superior to placebo on many of the outcome measures. Imipramine was superior to buspirone on the Patient Rated Global Improvement Scale and on the Investigator Rated Global Improvement Scale, but not on other measures. Although buspirone appeared to be more effective than placebo, differences were not statistically significant. Some buspirone patients did very well compared to others, suggesting a possible bimodal distribution of response. Patients on buspirone had fewer and less disruptive side effects than those on imipramine.
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The focus of this paper is the treatment of panic disorder with alprazolam. Drug treatments alone are sometimes not sufficient by themselves, to adequately control all of the symptoms or components of this disorder. In the typical case we can identify four targets of treatment: The first target is the biological core of the condition, that is characterized by the unexpected, unprovoked attacks of anxiety. This responds best to medication. The second target is the phobic avoidance behaviour. It appears to be a conditioned or learned complication of the biological core, and appears to follow the laws of learning theory. Unlearning treatments, like behaviour therapy (notably in vivo exposure) are usually necessary to make a full impact against the phobic avoidance behaviour. Thirdly, there is no drug that reverses the psycho-social problems these patients have. Not all of them have such problems, but those that do may need psychotherapy to deal with their conflicts and stresses. Finally, the evidence in several chronic studies, suggest that this is a chronic relapsing disorder in the majority of cases. It is not enough to treat these patients acutely. They must be followed chronically and monitored carefully over many years, if they are to be protected against relapse.
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