Treatment of panic disorder in older adults: A pilot study comparison of alprazolam, imipramine, and placebo

Javaid I. Sheikh, Pamela J. Swales

Research output: Contribution to journalArticle

26 Citations (Scopus)


Objective: Several studies have documented that a variety of pharmacological compounds are quite effective in controlling acute symptomatology of panic disorder in the general population. However, there is a paucity of such studies in the management of panic disorder in older adults (ages 55 and above). The purpose of this study was to gather pilot data in older patients with panic disorder to begin to assess the efficacy of two commonly-used antipanic medications, imipramine and alprazolam. Method: Twenty-five (n = 25 (23 females; 2 males); 18 completers, 7 dropouts) older panic disorder (DSM-III-R) patients (age range = 55-73; mean = 61.24) were studied in an eight-week randomized, parallel-groups, double-blind, placebo- controlled, flexible dose design. Outcome was assessed weekly by global change ratings (Hamilton Anxiety and Depression Scales; Physicians' Global Impression ratings) and panic diaries. Because of small sample size, we present data descriptively. Results: Subjects in active medication groups evidenced reductions in panic attacks and in levels of overall anxiety and depression. Therapeutic dosages were approximately half those commonly used in younger panic disorder patients. Conclusion: Our data suggest the comparable efficacy of alprazolam and imipramine in the short-term treatment of older adults with panic disorder. There is clearly the need for a larger scale placebo-controlled study, preferably comparing imipramine and/or alprazolam with one of the SSRIs, to substantiate our findings.

Original languageEnglish
Pages (from-to)107-117
Number of pages11
JournalInternational Journal of Psychiatry in Medicine
Issue number1
Publication statusPublished - 8 Jun 1999



  • Alprazolam and imipramine
  • Older adults
  • Panic disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this