Panic attacks and agoraphobia: low dose clomipramine treatment.

Seventeen outpatients with panic anxiety and agoraphobia were treated with a low, flexible dose of clomipramine in an 8-week open trial. Panic attacks ceased completely in 13 patients and markedly decreased in the other four without additional therapeutic measures. Avoidance behavior disappeared in five of the seven agoraphobic patients. Overall mean dosage was 45 mg/day, with eight patients receiving clomipramine 25 mg or less. Higher doses were needed when agoraphobia was present. These results are discussed in conjunction with previous findings and lend support to serotonergic involvement in panic anxiety. Further double-blind studies are needed to confirm these results.