Clonazepam in treatment of Panic Disorder with or without agoraphobia: Dose-Response Study of Efficacy, Safety, and Discontinuance

Clonazepam in treatment of Panic Disorder with or without agoraphobia: Dose-Response Study of Efficacy, Safety, and Discontinuance

Rosenbaum JF, Moroz G, Bowden CL. J Clin Psychopharmacol. 1997 Oct;17(5):390-400.

413 patients were randomly assigned to receive placebo or one of five fixed daily doses of clonazepam (0.5 mg, 1.0 mg, 2.0 mg, 3.0 mg, and 4.0 mg).
After 3 weeks of dose escalation, the fixed dose was given for 6 weeks (the dose-maintenance phase) and then was tapered during a 7-week discontinuance phase.

Results:
- The minimum effective dosage, as determined by the Williams' test, was 1.0 mg daily. Dose-response analysis showed that daily dosages of 1.0 mg and higher were equally efficacious in reducing the number of panic attacks.
- All treatments were well tolerated.
- Somnolence and ataxia were reported more often by patients in the 3.0- and 4.0-mg groups;
- depression, dizziness, fatigue, and irritability, although not showing dose-relatedness, were reported by more patients taking clonazepam than placebo.
- During the discontinuance phase, most patients worsened from their condition at the end of the dose-maintenance phase but did not revert to that at baseline.
- Daily doses of 1.0 to 2.0 mg of clonazepam offered the best balance of therapeutic benefit and tolerability.

Read the full study here: Journal of Clinical Psychopharmacology