A six-week double-blind placebo-controlled trial of fluvoxamine was undertaken in
46 patients suffering from panic disorder with or without agoraphobia diagnosed by
DSM-III-R guidelines. Average daily dosage of fluvoxamine was 160 mg, with a highest
permitted dose of 300 mg/day. Weekly evaluation included a diary in which the number,
severity, and duration of full-blown and limited panic attacks and the duration and
severity of anticipating fear, CAS, GAS, CGI, HAM-D, adverse effects and the number
of capsules not taken were noted. Fluvoxamine was not significantly superior to placebo
with regard to the main outcome criterion, i.e., the reduction in the number of panic
attacks, but it was significantly more effective with regard to the diminution in
the number of limited panic attacks and showed a tendency to significance in respect
of GAS and CGI. Plasma levels of fluvoxamine were measured at the end of week one
and at the end of the study. Most patients with complete remission at the end of the
study were found in the verum group with plasma fluvoxamine levels ranging from 10
to 100ng/ml. It is suggested that therapeutic response might be maximized by monitoring
fluvoxamine concentrations in blood.
