Clin Psychopharmacol Neurosci.  2017 Nov;15(4):382-390. 10.9758/cpn.2017.15.4.382.

Early Improvement and Marriage Are Determinants of the 12-Month Treatment Outcome of Paroxetine in Outpatients with Panic Disorder

Affiliations
  • 1Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan. takashiw@dokkyomed.ac.jp
  • 2Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Shimotsuga, Japan.
  • 3Mental Health Clinic SAKURA-RA, Utsunomiya, Japan.

Abstract

OBJECTIVE: In this study, we investigated the determinants of remission and discontinuation of paroxetine pharmacotherapy in outpatients with panic disorder (PD).
METHODS
Subjects were 79 outpatients diagnosed with PD who took 10–40 mg/day of paroxetine for 12 months. The candidate therapeutic determinants included the serotonin transporter gene-linked polymorphic region and the −1019C/G promoter polymorphism of the serotonin receptor 1A as genetic factors, educational background
and marital status as environmental factors, and early improvement (EI) at 2 weeks as a clinical factor were assessed. The Clinical Global Impression scale was used to assess the therapeutic effects of the pharmacotherapy.
RESULTS
Cox proportional hazards regression was performed to investigate the significant predictive factors of remission and discontinuation. EI was only a significant predictive factor of remission. EI was a significant predictive factor of remission (hazard ratio [HR], 2.709; 95% confidence interval [CI], 1.177–6.235). Otherwise, EI and marital status were significant predictive factors of the discontinuation. EI (HR, 0.266; 95% CI, 0.115–0.617) and being married (HR, 0.437; 95% CI, 0.204–0.939) were considered to reduce the risk of treatment discontinuation. In married subjects, EI was a significant predictive factor of the discontinuation (HR, 0.160; 95% CI, 0.045–0.565). However, in unmarried subjects, EI was not a significantly predictive factor for the discontinuation.
CONCLUSION
EI achievement appears to be a determinant of PD remission in paroxetine treatment. In married PD patients, EI achievement also appears to reduce a risk of discontinuation of paroxetine treatment.

Keyword

Paroxetine; Panic disorder; Marital status; Treatment outcome; Patient dropouts; Induction of remission
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