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Double-Blind, Controlled, Crossover Trial of Inositol Versus Fluvoxamine for the Treatment of Panic Disorder

Palatnik, Alex MD*; Frolov, Katerina MD*; Fux, Mendel MD*; Benjamin, Jonathan MD

Journal of Clinical Psychopharmacology: June 2001 - Volume 21 - Issue 3 - p 335-339
Brief Reports
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Only 70% of patients respond to current treatments for panic disorder, and many discontinue drugs because of side effects. myo-Inositol, a natural isomer of glucose and a precursor for the second-messenger phosphatidyl-inositol system, has previously been found superior to placebo in the treatment of depression, panic disorder, and obsessive-compulsive disorder (OCD), but a direct comparison with an established drug has never been performed. A double-blind, controlled, random-order crossover study was undertaken to compare the effect of inositol with that of fluvoxamine in panic disorder. Twenty patients completed 1 month of inositol up to 18 g/day and 1 month of fluvoxamine up to 150 mg/day. Improvements on Hamilton Rating Scale for Anxiety scores, agoraphobia scores, and Clinical Global Impressions Scale scores were similar for both treatments. In the first month, inositol reduced the number of panic attacks per week (mean and SD) by 4.0 (2) compared with a reduction of 2.4 (2) with fluvoxamine (p = 0.049). Nausea and tiredness were more common with fluvoxamine (p = 0.02 and p = 0.01, respectively). Because inositol is a natural compound with few known side effects, it is attractive to patients who are ambivalent about taking psychiatric medication. Continuing reports of inositol’s efficacy in the treatment of depression, panic disorder, and OCD should stimulate replication studies.

*Ministry of Health Mental Health Center, Faculty of Health Sciences, and †Department of Psychiatry, Soroka Medical Center of the Kupat Holim Sick Fund, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheba, Israel

Received January 31, 2000; accepted after revision July 14, 2000.

Address requests for reprints to: Jonathan Benjamin, MD, Psychiatry Department, Barzilaí Medical Center, Histadrut Street, Ashkelon 78306, Israel. Address e-mail to: yonatan@bgumail.bgu.ac.il.

© 2001 Lippincott Williams & Wilkins, Inc.