Sertraline and Alprazolam in the Treatment of Panic Desorder

A compared,  week, placebo controlled study, with fi xed dose, outpatient study of patients diagnosed with panic disorder with and without agoraphobia according to ICD-, was conducted to evaluate the effi cacy and safety of sertraline and alprazolam. Th e study included  patients, divided in two groups. We evaluated number of ICD--defi ned panic attacks, agoraphobia and anticipatory anxiety. All patients were aged  year and older and were randomized to either sertraline or alprazolam. Sertraline applied in fi xed doses of  mg/day and alprazolam in doses -, mg/day signifi cantly reduced the frequency of panic attacks in panic disorder patients, reduced symptoms of agoraphobia and anticipatory anxiety.

FIŠEKOVIĆ SAIDA, LOGA-ZEC SVJETLANA: SERTRALINE AND ALPRAZOLAM IN THE TREATMENT OF PANIC DESORDER

Introduction
Panic disorder implied possible effi ciency of the selective serotonin reuptake inhibitor (SSRI) in the treatment ().Lifetime prevalence in the USA and Europe is .Very often this disorder aff ects young population ().Sertraline is a specifi c and potent, highly selective SSRI which can be used in the treatment of panic disorder with or without agoraphobia (,).Generally, panic disorders and panic attacks aff ect approximately  of the general population.Th is study examines the eff ects of prior benzodiazepine treatment, alprazolam compared to the current treatment with sertraline among patients with panic disorder with or without agoraphobia.It is well known that the majority of patients with panic disorder are treated with benzodiazepines, but the eff ectiveness of this therapy is insuffi cient, especially in cases where agoraphobia and anticipating anxiety were present ().

Patients and Methodology
This study involved  patients treated at the out-patient department with diagnosed panic disorder with or without agoraphobia according to the ICD- criteria.
All patients were older than .Th ey were divided into the two groups.First group of  patients was treated with  mg/day of sertraline, and second ( patients) with -, mg/day of alprazolam over  weeks period.In this research a questionnaire was applied that consisted of basic social and demographic data, Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD), as well as questionnaire about the side eff ects of the applied medications.

Results
Table .presents gender structure of the sample.We can notice that there is no statistically signifi cant diff erence, although there are slightly more women in the group treated with sertraline.Table .displays the age structure of the sample.We can notice that the most dominant age group is - for those treated with sertraline, and - for those treated with alprazolam.Th ere is no statistically signifi cant diff erence between the groups.Table .presents the mean values of age in both groups, which does not differ significantly.The mean age in the group of patients treated with sertraline is  years; while in the group of patients treated with alprazolam is FIŠEKOVIĆ SAIDA, LOGA-ZEC SVJETLANA: SERTRALINE AND ALPRAZOLAM IN THE TREATMENT OF PANIC DESORDER , years.Table .presents comparison of the results at the Hamilton Rating Scale for Depression (HAMD) between the two groups, where we can see depressive symptoms decreased at the end of the second week that in the group of patients treated with sertraline (p<,).At the Chart . results of the Hamilton Rating Scale for Anxiety are presented.It is noticeable that in the group of patients treated with SSRI, beside the higher initial scores, there was a signifi cant decrease of anxiety symptoms after the second week, compared to alprazolam.Group treated with alprazolam shows less effects of the medication in terms of reliving anxiety symptoms after the third week.Chart . shows the frequencies of panic attacks and anticipating anxiety.It is noticeable that in the group of patients treated with SSRI, already during the second week, among  of patients panic attacks disappeared, while anticipating anxiety disappeared in  of cases.After the fourth week Panic attacks and anticipating anxiety completely withdrew.(p<,).It is noticeable in the Chart . that fears sig-nifi cantly decreased among patients treated sertraline and alprazolam, although patients treated with sertraline felt the eff ect of the medication somewhat sooner, or to be more precise during the third week (P<,).