, Volume 194, Issue 2, pp 233–242 | Cite as

A randomized controlled trial of venlafaxine ER and paroxetine in the treatment of outpatients with panic disorder

  • Mark Pollack
  • Richard Mangano
  • Richard Entsuah
  • Evan Tzanis
  • Naomi M. Simon
Original Investigation



Few randomized, placebo-controlled trials have evaluated the comparative efficacy and tolerability of more than one pharmacological agent for panic disorder.


The primary objective of this study was to compare the efficacy and tolerability of venlafaxine extended release (ER) with placebo in treating panic disorder. Secondary objectives included comparing paroxetine with venlafaxine ER and placebo.


Outpatients aged ≥18 years (placebo, n = 157; venlafaxine ER 75 mg, n = 156; venlafaxine ER 225 mg, n = 160; paroxetine, n = 151), with a primary diagnosis of panic disorder (±agoraphobia) based on the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for ≥3 months were randomly assigned to receive venlafaxine ER (titrated to 75 mg/day or 225 mg/day), paroxetine (titrated to 40 mg/day), or placebo for 12 weeks. The primary efficacy measure was the percentage of patients free of full-symptom panic attacks (≥ four symptoms) at endpoint. Key secondary outcomes included the Panic Disorder Severity Scale (PDSS) mean score change and response.


At endpoint, all active treatment groups showed a significantly (P < 0.01) greater proportion of patients free of full-symptom panic attacks, compared with placebo, and were superior (P < 0.05) on most secondary measures. The venlafaxine ER 225 mg group had significantly (P < 0.05) greater mean PDSS score improvement than the paroxetine group (−12.58 vs −11.87) and a significantly higher proportion of patients free of full symptom panic attacks (70.0 vs 58.3%). Both drugs were generally well tolerated.


Venlafaxine ER 75 mg/days and 225 mg/days and paroxetine 40 mg/day were both well tolerated and effective for short-term treatment of panic disorder.


Venlafaxine Paroxetine Panic disorder Agoraphobia Pharmacotherapy Panic attack 



The authors would like to acknowledge Michael Rennert, PhD for his editorial assistance on this manuscript. Funding for this study was provided by Wyeth Research, Collegeville, Pennsylvania.


Mark Pollack, MD

Advisory boards and consultation

AstraZeneca, Brain Cells, Bristol Myers Squibb, Cephalon, Forest Laboratories, GlaxoSmithKline, Janssen, Jazz Pharmaceuticals, Eli Lilly, Medavante, Neurocrine, Neurogen, Novartis, Otsuka Pharmaceuticals, Pfizer, Predix, Roche, Laboratories, Sanofi, Sepracor, Solvay, Tikvah Therapeutics, Transoral Pharmaceuticals, UCB Pharma, Wyeth

Research grants

Bristol Myers Squibb, Cephalon, Forest Laboratories, GlaxoSmithKline, Janssen, Eli Lilly, NARSAD, NIDA NIMH, Pfizer, Sepracor, UCB Pharma, Wyeth

Speaker programs

Bristol Myers Squibb, Forest Laboratories, GlaxoSmithKline, Janssen, Lilly, Pfizer, Solvay, Wyeth


Medavante, Mensante

Naomi Simon, MD, MSc

Research support

Astra Zeneca, Cephalon, Forest Laboratories, Glaxo SmithKline, Janssen, Eli Lilly Inc., NARSAD, NIMH, Pfizer, Inc., UCB- Pharma, Sepracor


Paramount Biosciences, Solvay


Forest Laboratories, Janssen, Eli Lilly Inc., Pfizer, Inc., UCB- Pharma, Sepracor

Richard Entsuah, PhD and Evan Tzanis are employees of Wyeth. Richard Mangano, PhD is a former Wyeth employee but was an employee of Wyeth at the time the study was conducted and the manuscript was written.

All authors confirm that they have provided significant input in the study design, collection, analysis, and interpretation of data and writing the reports. They have had full control of all primary data and agree to allow the journal to review the data if requested.


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Mark Pollack
    • 1
  • Richard Mangano
    • 2
  • Richard Entsuah
    • 2
  • Evan Tzanis
    • 2
  • Naomi M. Simon
    • 1
  1. 1.Massachusetts General HospitalBostonUSA
  2. 2.Wyeth ResearchCollegevilleUSA

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