This article is more than 5 years old. Information may no longer be current.
Panic disorder may increase risk for antidepressant side effects
Click Here to Manage Email Alerts
Antidepressant side effects were more common among individuals with depression and comorbid panic disorder than those without panic disorder, according to recent findings.
“People with panic disorder are especially sensitive to changes in their bodies. It’s called ‘interoceptive awareness,’” Stewart A. Shankman, PhD, of the University of Illinois at Chicago, said in a press release. “Because these patients experience panic attacks — which are sudden, out-of-nowhere symptoms that include heart racing, shortness of breath, and feeling like you’re going to die — they are acutely attuned to changes in their bodies that may signal another panic attack coming on. So it does make sense that these tuned-in patients report more physiological side effects with antidepressant treatment.”
To determine if antidepressant side effects were more common among individuals with depression and comorbid panic disorder, researchers assessed individuals with chronic depression who received antidepressants for 12 weeks (n = 808). Depressive symptoms and side effects were measured every 2 weeks.
Individuals with a lifetime diagnosis of panic disorder at baseline were more likely to have gastrointestinal (OR = 1.6; 95% CI, 1-2.6), cardiac (OR = 1.8; 95% CI, 1.1-3.1), neurologic (OR = 2.6; 95% CI, 1.6-4.2) and genitourinary (OR = 3; 95% CI, 1.7-5.3) side effects.
Increases in depressive symptoms among individuals with panic disorder were significantly associated with increases in side effect frequency, intensity and impairment over time, compared with those without comorbid panic disorder.
Social phobia and generalized anxiety disorder were not associated with these effects.
“The study results suggest that chronically depressed patients with comorbid panic disorder, but not comorbid [generalized anxiety disorder] or social phobia, have greater likelihood of reporting gastrointestinal, cardiac, neurologic, and genitourinary difficulties during antidepressant treatment,” the researchers wrote. “The burden of these side effects (in frequency, severity, and [at a trend level] impairment) were associated with worse depressive symptoms during treatment in patients with comorbid panic disorder than in those without comorbid panic disorder, and these effects were not observed for [generalized anxiety disorder] or social phobia. Clinicians working with these difficult-to-treat patients should perform a detailed assessment of side effect profiles to maximize the efficacy of their antidepressant treatment.” – by Amanda Oldt
Disclosure: Shankman reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.