This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

David V. Sheehan, MB, Bch, BAO; James Ballenger, MD; Gary Jacobsen, MD

Arch Gen Psychiatry. 1980;37(1):51-59.

Abstract
• Endogenous anxiety (anxiety hysteria, agoraphobia with panic attacks) is characterized by sudden, spontaneous panic attacks accompanied by multiple autonomic symptoms, overwhelming fear, a flight response, and polyphobic behavior. Psychotherapy, behavior therapy, and tranquilizers have been of limited success in treating this syndrome. Fifty-seven patients severely disabled by the syndrome for a mean period of 13 years completed the three-month study. Randomly assigned in a double-blind, placebo-controlled design to imipramine hydrochloride, phenelzine sulfate, or placebo, they were seen in supportive group therapy every two weeks. Patients in the phenelzine and imipramine cells showed significant improvement over patients in the placebo group and over baseline on all outcome measures. The persistent trend for phenelzine to be superior to imipramine achieved significance only on the Work and Social Disability Scale and the Symptom Severity and Phobic Avoidance Scale. The implications for classification and theory are discussed.

Author Affiliations
From the Department of Psychosomatic Medicine Clinic, Massachusetts General Hospital, and Harvard Medical School, Boston (Dr Sheehan), the Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, Md (Dr Ballenger), and Westwood Lodge Hospital, Westwood, Mass (Dr Jacobsen). Dr Ballenger is now with the Department of Behavioral Medicine and Psychiatry, University of Virginia School of Medicine, Charlottesville.

Footnotes
Accepted for publication Oct 25, 1978.

Reprint requests to Psychosomatic Medicine Clinic, Massachusetts General Hospital, Fruit St, Boston, MA 02114 (Dr Sheehan).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Co-occurrence of Insomnia and Anxiety Disorders: A Review of the Literature
Marcks and Weisberg
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2009;3:300-309.
ABSTRACT  

Psychotherapy Plus Antidepressant for Panic Disorder With or Without Agoraphobia: Systematic Review
Furukawa et al.
Focus 2008;6:528-538.
ABSTRACT | FULL TEXT  

Eszopiclone Coadministered With Escitalopram in Patients With Insomnia and Comorbid Generalized Anxiety Disorder
Pollack et al.
Arch Gen Psychiatry 2008;65:551-562.
ABSTRACT | FULL TEXT  

Psychotherapy plus antidepressant for panic disorder with or without agoraphobia: Systematic review
FURUKAWA et al.
Br. J. Psychiatry 2006;188:305-312.
ABSTRACT | FULL TEXT  

Diagnosis and management of anxiety disorders.
Shelton
JAOA: Journal of the American Osteopathic Association 2004;104:S2-S5.
ABSTRACT | FULL TEXT  

Atypical Depression: A Reappraisal
Parker et al.
Am. J. Psychiatry 2002;159:1470-1479.
ABSTRACT | FULL TEXT  

A 28-Year-Old Woman With Panic Disorder
Gorman
JAMA 2001;286:450-457.
FULL TEXT  

A dose-finding and discontinuation study of clomipramine in panic disorder
Lotufo-Neto et al.
J Psychopharmacol 2001;15:13-17.
ABSTRACT  

Comparison of Aerobic Exercise, Clomipramine, and Placebo in the Treatment of Panic Disorder
Broocks et al.
Am. J. Psychiatry 1998;155:603-609.
ABSTRACT | FULL TEXT  

Stopping panic attacks
DTB 1997;35:58-62.
ABSTRACT | FULL TEXT  

Unrecognized Paroxysmal Supraventricular Tachycardia: Potential for Misdiagnosis as Panic Disorder
Lessmeier et al.
Arch Intern Med 1997;157:537-543.
ABSTRACT  

Somatized Psychiatric Disorder Presenting as Palpitations
Barsky et al.
Arch Intern Med 1996;156:1102-1108.
ABSTRACT  

Hypochondriasis and Panic Disorder: Boundary and Overlap
Barsky et al.
Arch Gen Psychiatry 1994;51:918-925.
ABSTRACT  

Fortnightly Review: Treatment of anxiety
Lader
BMJ 1994;309:321-324.
FULL TEXT  

Maintenance Drug Treatment of Panic Disorder: I. Results of a Prospective, Placebo-Controlled Comparison of Alprazolam and Imipramine
Schweizer et al.
Arch Gen Psychiatry 1993;50:51-60.
ABSTRACT  

Psychiatric Comorbidity in DSM-III-R Hypochondriasis
Barsky et al.
Arch Gen Psychiatry 1992;49:101-108.
ABSTRACT  

Update on Anxiety Disorders
Ballenger
Arch Intern Med 1991;151:857-859.
ABSTRACT  

A Practical Update on Anxiety Disorders and Their Pharmacologic Treatment
Brown et al.
Arch Intern Med 1991;151:873-884.
ABSTRACT  

Response to Phenelzine and Imipramine in Placebo Nonresponders With Atypical Depression: A New Application of the Crossover Design
Quitkin et al.
Arch Gen Psychiatry 1991;48:319-323.
ABSTRACT  

Imipramine in panic disorder. 1. Clinical response and pharmacological changes
Nutt and Glue
J Psychopharmacol 1991;5:56-64.
ABSTRACT  

Needs of High Functioning Teenagers and Adults with Autism (Tips From a Recovered Autistic)
Grandin
Focus Autism Other Dev Disabl 1990;5:1-16.
ABSTRACT  

Treatment of Panic Disorder
Hayes
Journal of Pharmacy Practice 1990;3:233-240.
ABSTRACT  

A 6-Year Follow-up of the Effectiveness of Respiratory Retraining, In-situ Isometric Relaxation, and Cognitive Modification in the Treatment of Agoraphobia
Franklin
Behav Modif 1989;13:139-167.
ABSTRACT  

Electroencephalographic Sleep in Panic Disorder: A Focus on Sleep-Related Panic Attacks
Mellman and Uhde
Arch Gen Psychiatry 1989;46:178-184.
ABSTRACT  

Overview of the Cross-National Collaborative Panic Study: I. Efficacy in Short-term Treatment
Klerman
Arch Gen Psychiatry 1988;45:407-412.
ABSTRACT  

Alprazolam in Panic Disorder and Agoraphobia: Results From a Multicenter Trial: I. Efficacy in Short-term Treatment
Ballenger et al.
Arch Gen Psychiatry 1988;45:413-422.
ABSTRACT  

Alprazolam in Panic Disorder and Agoraphobia: Results From a Multicenter Trial: II. Patient Acceptance, Side Effects, and Safety
Noyes et al.
Arch Gen Psychiatry 1988;45:423-428.
ABSTRACT  

Secondary Depression in Panic Disorder and Agoraphobia: I. Frequency, Severity, and Response to Treatment
Lesser et al.
Arch Gen Psychiatry 1988;45:437-443.
ABSTRACT  

Clomipramine Treatment of Agoraphobic Women: An Eight-Week Controlled Trial
Johnston et al.
Arch Gen Psychiatry 1988;45:453-459.
ABSTRACT  

The Cause and Treatment of Agoraphobia-Reply
Klein
Arch Gen Psychiatry 1988;45:389-392.
ABSTRACT  

An Efficacy Study of Isocarboxazid and Placebo in Depression, and Its Relationship to Depressive Nosology
Davidson et al.
Arch Gen Psychiatry 1988;45:120-127.
ABSTRACT  

Antidepressant Specificity in Atypical Depression
Liebowitz et al.
Arch Gen Psychiatry 1988;45:129-137.
ABSTRACT  

Hypochondriasis and Somatization
Kellner
JAMA 1987;258:2718-2722.
ABSTRACT  

Agoraphobia With Panic Attacks: Development, Diagnostic Stability, and Course of Illness
Breier et al.
Arch Gen Psychiatry 1986;43:1029-1036.
ABSTRACT  

Effects of One Night's Sleep Deprivation on Mood and Behavior in Panic Disorder: Patients With Panic Disorder Compared With Depressed Patients and Normal Controls
Roy-Byrne et al.
Arch Gen Psychiatry 1986;43:895-899.
ABSTRACT  

Carbon Dioxide Sensitivity in Panic Anxiety: Ventilatory and Anxiogenic Response to Carbon Dioxide in Healthy Subjects and Patients With Panic Anxiety Before and After Alprazolam Treatment
Woods et al.
Arch Gen Psychiatry 1986;43:900-909.
ABSTRACT  

Treatment Outcome Validation of DSM-III Depressive Subtypes: Clinical Usefulness in Outpatients With Mild to Moderate Depression
Stewart et al.
Arch Gen Psychiatry 1985;42:1148-1153.
ABSTRACT  

Functional Somatic Symptoms and Hypochondriasis: A Survey of Empirical Studies
Kellner
Arch Gen Psychiatry 1985;42:821-833.
ABSTRACT  

Social Phobia: Review of a Neglected Anxiety Disorder
Liebowitz et al.
Arch Gen Psychiatry 1985;42:729-736.
ABSTRACT  

Noradrenergic Function and the Mechanism of Action of Antianxiety Treatment: I. The Effect of Long-term Alprazolam Treatment
Charney and Heninger
Arch Gen Psychiatry 1985;42:458-467.
ABSTRACT  

Noradrenergic Function and the Mechanism of Action of Antianxiety Treatment: II. The Effect of Long-term Imipramine Treatment
Charney and Heninger
Arch Gen Psychiatry 1985;42:473-481.
ABSTRACT  

Major Depression in Patients With Agoraphobia and Panic Disorder
Breier et al.
Arch Gen Psychiatry 1984;41:1129-1135.
ABSTRACT  

Platelet {alpha}2-Adrenergic Receptor Binding and Plasma Catecholamines: Before and During Imipramine Treatment in Patients With Panic Anxiety
Cameron et al.
Arch Gen Psychiatry 1984;41:1144-1148.
ABSTRACT  

Noradrenergic Function in Panic Anxiety: Effects of Yohimbine in Healthy Subjects and Patients With Agoraphobia and Panic Disorder
Charney et al.
Arch Gen Psychiatry 1984;41:751-763.
ABSTRACT  

Lactate Provocation of Panic Attacks: I. Clinical and Behavioral Findings
Liebowitz et al.
Arch Gen Psychiatry 1984;41:764-770.
ABSTRACT  

Adrenergic Function in Patients With Panic Anxiety
Nesse et al.
Arch Gen Psychiatry 1984;41:771-776.
ABSTRACT  

Phenelzine v Imipramine in Atypical Depression: A Preliminary Report
Liebowitz et al.
Arch Gen Psychiatry 1984;41:669-677.
ABSTRACT  

The Anxiety Disorders
BROWN et al.
ANN INTERN MED 1984;100:558-564.
ABSTRACT  

Diazepam and Propranolol in Panic Disorder and Agoraphobia
Noyes et al.
Arch Gen Psychiatry 1984;41:287-292.
ABSTRACT  

Genetic Factors in Anxiety Disorders
Torgersen
Arch Gen Psychiatry 1983;40:1085-1089.
ABSTRACT  

Obsessive-Compulsive Disorder: A Double-blind Trial of Clomipramine and Clorgyline
Insel et al.
Arch Gen Psychiatry 1983;40:605-612.
ABSTRACT  

Panic-Induced Elevation of Plasma MHPG Levels in Phobic-Anxious Patients: Effects of Clonidine and Imipramine
Ko et al.
Arch Gen Psychiatry 1983;40:425-430.
ABSTRACT  

Treatment of Phobias: I. Comparison of Imipramine Hydrochloride and Placebo
Zitrin et al.
Arch Gen Psychiatry 1983;40:125-138.
ABSTRACT  

Imipramine and Brief Therapist-Aided Exposure in Agoraphobics Having Self-exposure Homework
Marks et al.
Arch Gen Psychiatry 1983;40:153-162.
ABSTRACT  

Treatment of Agoraphobia and Panic Attacks
Matuzas and Glass
Arch Gen Psychiatry 1983;40:220-222.
ABSTRACT  

Response to Phenelzine and Amitriptyline in Subtypes of Outpatient Depression
Paykel et al.
Arch Gen Psychiatry 1982;39:1041-1049.
ABSTRACT  

Neurotransmitters in Anxiety
Hoehn-Saric
Arch Gen Psychiatry 1982;39:735-742.
ABSTRACT  

Effects of Clonidine on Anxiety Disorders
Hoehn-Saric et al.
Arch Gen Psychiatry 1981;38:1278-1282.
ABSTRACT  

Affective Disorder and Alcoholism in Families of Agoraphobics
Munjack and Moss
Arch Gen Psychiatry 1981;38:869-871.
ABSTRACT  

Phenelzine and Amitriptyline in the Treatment of Depression: A Comparison of Present and Past Studies
Ravaris et al.
Arch Gen Psychiatry 1980;37:1075-1080.
ABSTRACT