fluvoxamine and brofaromine

Differences between responders and non-responders to drug therapy were investigated in social phobia. Two previously published studies were pooled to obtain data of 30 patients who were treated for 12 weeks with brofaromine or fluvoxamine. Four criterion variables were used to divide patients in responders and non-responders. Depending on the criterion variable up to 72% of the patients were regarded as responders. Non-responders differed from responders in that they had a higher heart rate and a higher blood pressure. They were also characterized by higher scores on several psychometric scales, indicative of illness severity.

Topics: Adult; Arousal; Blood Pressure; Double-Blind Method; Female; Fluvoxamine; Heart Rate; Humans; Male; Middle Aged; Monoamine Oxidase Inhibitors; Personality Inventory; Phobic Disorders; Piperidines; Prognosis; Selective Serotonin Reuptake Inhibitors; Treatment Outcome

Previous studies have shown that both selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) are effective in the treatment of panic disorders (PD). In this study, the SSRI fluvoxamine (Fluv) was compared with the MAO-A-I brofaromine (Brof). Thirty patients with the diagnosis of PD with or without agoraphobia were treated with either Fluv or Brof (150 mg daily) in a double-blind design. After 12 weeks of treatment, 93% of the Brof group and 87% of the Fluv group considered themselves much or very much improved. Taking a reduction in the Hamilton Rating Scale for Anxiety score of 50% or more, 33% of the Fluv patients and 47% of the Brof patients were responders to treatment. After an increase in anxiety in the 1st week, which was more severe in Fluv-treated patients than for Brof, a clinically relevant decrease in anxiety symptoms and reduction in panic attacks and avoidance behavior was observed. There was no significant difference between the treatment groups. The most prominent side effects were middle-sleep disturbance (Brof), tiredness (Fluv), and nausea after taking the medication (Brof and Fluv). During a double-blind follow-up period of another 12 weeks, a further improvement was found in both treatment groups without significant differences between the two groups. The selective and reversible MAO-A-I brofaromine and the SSRI fluvoxamine are equally effective in the treatment of PD. Both compounds lead to a reduction in the number of panic attacks and a subsequent reduction in agoraphobic avoidance.

Topics: Adult; Anti-Anxiety Agents; Double-Blind Method; Female; Fluvoxamine; Headache; Humans; Male; Middle Aged; Monoamine Oxidase Inhibitors; Nausea; Panic Disorder; Piperidines; Selective Serotonin Reuptake Inhibitors

Little is known about biological predictors of treatment response in panic disorder (PD). In the present study heart rate, blood pressure, plasma cortisol and plasma MHPG were investigated at baseline in a sample of 44 PD patients as possible predictors for nonresponse to treatment. We used a strict definition of nonresponse to find patients who did not respond at all after 12 weeks of treatment with brofaromine or fluvoxamine. Patients were considered nonresponders when they fulfilled two criteria: they did not show a 50% reduction of agoraphobic avoidance and they still experienced panic attacks at endpoint. The variables that differed significantly between the groups were used to predict nonresponse to drug therapy. Using this strict definition of nonresponse, 15 patients (32.6%) were considered nonresponders. These patients were characterised by a higher plasma MHPG concentration and a higher heart rate at baseline. These variables were subsequently used to predict nonresponse.

Topics: Adult; Biomarkers; Blood Pressure; Double-Blind Method; Female; Fluvoxamine; Heart Rate; Humans; Hydrocortisone; Male; Methoxyhydroxyphenylglycol; Middle Aged; Monoamine Oxidase Inhibitors; Panic Disorder; Piperidines; Selective Serotonin Reuptake Inhibitors; Treatment Failure

Factors that predict nonresponse to drug therapy (brofaromine or fluvoxamine) were investigated in a sample of 44 panic disorder patients. We used a strict definition of nonresponse to find patients who did not respond at all after 12 weeks of treatment. Using this definition, 15 patients (32.6%) were considered nonresponders. Nonresponders had a higher score on the Blood-Injury subscore of the Fear Questionnaire (FQ) and more often had high scores on several FQ subscores, indicative of comorbid phobic symptoms. These variables were subsequently used to predict nonresponse.

Topics: Adult; Agoraphobia; Double-Blind Method; Female; Fluvoxamine; Humans; Male; Middle Aged; Monoamine Oxidase Inhibitors; Panic; Panic Disorder; Personality Inventory; Phobic Disorders; Piperidines; Prognosis; Treatment Outcome

Topics: Analysis of Variance; Animals; Antidepressive Agents; Clomipramine; Clorgyline; Fluvoxamine; Frontal Lobe; Hydroxyindoleacetic Acid; Imipramine; Microdialysis; Monoamine Oxidase Inhibitors; Piperidines; Pyrimidines; Raphe Nuclei; Rats; Serotonin; Stereotaxic Techniques; Tranylcypromine; Tryptophan