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Latency to selective serotonin reuptake inhibitor vs benzodiazepine treatment in patients with panic disorder: a naturalistic study

Published online by Cambridge University Press:  05 November 2021

Eleonora Piccoli Open the ORCID record for Eleonora Piccoli [Opens in a new window] ,
Irma Bergamaschini ,
Laura Molteni ,
Simone Vanzetto ,
Alberto Varinelli ,
Caterina Viganò ,
Gabriele Catania ,
David S. Baldwin ,
Katharina Domschke  and
Bernardo Dell’Osso Open the ORCID record for Bernardo Dell’Osso [Opens in a new window]
Eleonora Piccoli*
Affiliation:
Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
Irma Bergamaschini
Affiliation:
Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
Laura Molteni
Affiliation:
Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
Simone Vanzetto
Affiliation:
Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
Alberto Varinelli
Affiliation:
Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
Caterina Viganò
Affiliation:
Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
Gabriele Catania
Affiliation:
Nucleo Operativo Terapia Cognitivo Comportamentale (N.O.Te.C.), Luigi Sacco University Hospital of Milan, Milan, Italy
David S. Baldwin
Affiliation:
Department of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Katharina Domschke
Affiliation:
Department of Psychiatry and Psychotherapy Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
Bernardo Dell’Osso
Affiliation:
Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, California, USA “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
*
*Author for correspondence: Eleonora Piccoli Email: eleonora.piccoli@unimi.it
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Abstract

Background

Panic disorder (PD) is a prevalent and impairing anxiety disorder with previous reports suggesting that the longer the condition remains untreated, the greater the likelihood of nonresponse. However, patients with PD may wait for years before receiving a guideline-recommended pharmacological treatment. The widespread prescription of benzodiazepines (BDZ) for managing anxiety symptoms and disorders might delay the administration of pharmacotherapy according to guidelines (eg, selective serotonin reuptake inhibitors, SSRIs). The present study aimed to determine the mean duration of untreated illness (DUI) in a sample of PD patients, to quantify and compare DUI-SSRI to DUI-BDZ, and to compare findings with those from previous investigations.

Methods

Three hundred and fourteen patients with a Diagnostic and Statistical Manual of Mental Disorders, fifth edition diagnosis of PD were recruited from an Italian outpatient psychotherapy unit, and epidemiological and clinical variables were retrieved from medical records. Descriptive statistical analyses were undertaken for sociodemographic and clinical variables, Wilcoxon matched-pair signed rank test was applied to compare the distribution of DUI-SSRI vs DUI-BDZ, and Welch’s t test was performed to compare findings with those from previous studies.

Results

The mean DUI-SSRI of the total sample was 64.25 ± 112.74 months, while the mean DUI-BDZ was significantly shorter (35.09 ± 78.62 months; P < 0.0001). A significantly longer DUI-SSRI, compared to findings from previous studies, was also observed.

Conclusions

The present results confirm a substantial delay in implementing adequate pharmacological treatments in patients with PD, and highlight the discrepancy between recommendations from international treatment guidelines and common clinical practice in relation to BDZ prescription.

Keywords

Psychopharmacologypanic disorderanxiety disordersduration of untreated illnesstreatment
Type
Original Research
Information
CNS Spectrums , Volume 28 , Issue 1 , February 2023 , pp. 46 - 52
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

In collaboration with the European College of Neuropsychopharmacology (ECNP) Anxiety Disorders Research Network (ADRN) Thematic Working Group.

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