Antidepressant drugs in anxiety disorders.

The efficacy of tricyclic antidepressants and monoamine oxidase inhibitors (MAOI) in the treatment of panic syndromes (panic disorder and agoraphobia with panic attacks) and obsessive-compulsive disorders is reviewed. Imipramine has been reported as significantly more effective against panic attacks than placebo or other psychoactive drugs in 12 of 16 studies. Clomipramine has been found superior to placebo or other psychoactive drugs in 5 controlled studies. The effectiveness of these drugs is also reflected in a large number of open trials. The MAOI phenelzine has been reported to be effective in 5 controlled studies. Clomipramine is the best documented drug in the treatment of obsessive-compulsive disorders. Its effectiveness has been documented in 7 controlled studies. Most investigators consider the effects in panic syndromes as well as in obsessive-compulsive disorders to be unrelated to the antidepressant effect.