Abstract
The time course and the phenomenology of the initial response to clomipramine (10-20 mg/day) was investigated in 70 patients with panic disorder with or without agoraphobia. Nineteen (27.1%) patients reported worsening of their clinical state which, on average, began 28 h after the first dose and lasted for 5 days. Increase in the frequency and severity of panic attacks was the most frequent finding (14 patients), followed by psycho- stimulant (jitteriness; n=9), depressive (n=8) and tonic anxiety symptoms (n=7). This pattern of initial worsening is different from the 'jitteriness syndrome' described for other antidepressants. Its implications for the understanding of the pathophysiology of panic disorder are discussed.
Get full access to this article
View all access options for this article.
