
Moclobemide
and fluoxetine for panic disorder
International Panic Disorder Study Group
Tiller JW, Bouwer C, Behnke K
Department of Psychiatry,
The University of Melbourne,
The Royal Melbourne Hospital,
Victoria, Australia.
Eur Arch Psychiatry Clin Neurosci 1999; 249 Suppl 1:S7-10
ABSTRACT
An international,
multicentre, double blind parallel group study compared the tolerability and
efficacy of moclobemide with the selective serotonin reuptake inhibitor (SSRI)
fluoxetine for panic disorder. SSRIs have been shown effective for panic. The
target dose of moclobemide was 450 mg and of fluoxetine was 20 mg. There were
two consecutive studies. An eight week study of acute adverse events,
tolerability and efficacy was followed by a long-term extension study to 1
year. The efficacy data showed no significant difference between moclobemide
and fluoxetine. Both had acute efficacy, with 63% moclobemide and 70%
fluoxetine patients (ns) panic free at 8 weeks. Both agents were well
tolerated to 8 weeks, but moclobemide had fewer severe adverse events (5) than
fluoxetine (9). There were no severe adverse events in the extension phase
with either drug, and almost all patients completing 1 year extension
treatment (moclobemide 61 patients, fluoxetine 65) were much or very much
improved. These data suggest moclobemide and fluoxetine are tolerated and
effective for both acute panic treatment and maintenance therapy.