This naturalistic study examined the treatment response to imipramine of
60 patients who had panic disorder or agoraphobia with panic attacks. Only
half of the patients could tolerate the drug, but of those who did, 88%
obtained a markedly beneficial clinical effect. An amphetamine-like side
effect accounted for most of the dropouts. More than one-half of the
responders achieved clinical remission at doses (less than or equal to 100
mg/day) and plasma levels (less than or equal to 150 ng/ml) considered to
be subtherapeutic for depression. There appears to be neither a clear
threshold for response nor a therapeutic dose range for imipramine in the
treatment of panic. Doses should be adjusted individually and increased
conservatively.Abstract Teaser