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Review
. 2014 Sep 30;2014(9):CD010828.
doi: 10.1002/14651858.CD010828.pub2.

Azapirones versus placebo for panic disorder in adults

Hissei Imai  1 , Aran Tajika, Peiyao Chen, Alessandro Pompoli, Giuseppe Guaiana, Mariasole Castellazzi, Irene Bighelli, Francesca Girlanda, Corrado Barbui, Markus Koesters, Andrea Cipriani, Toshi A Furukawa
Affiliations
Review

Azapirones versus placebo for panic disorder in adults

Hissei Imai et al. Cochrane Database Syst Rev. .

Abstract

Background: Panic disorder is common in the general population. It is often associated with other psychiatric disorders, such as drug dependence, major depression, bipolar disorder, social phobia, specific phobia and generalised anxiety disorder. Azapirones are a class of drugs used as anxiolytics. They are associated with less drowsiness, psychomotor impairment, alcohol potentiation and potential for addiction or abuse than benzodiazepines. However, azapirones are not widely used in the treatment of panic disorder and evidence for their efficacy is unclear. It is important to find out if azapirones are effective and acceptable in the treatment of panic disorder.

Objectives: To assess the effects of azapirones on panic disorder in adults, specifically:1. to determine the efficacy of azapirones in alleviating symptoms of panic disorder, with or without agoraphobia, in comparison with placebo;2. to review the acceptability of azapirones in panic disorder, with or without agoraphobia, in comparison with placebo; and3. to investigate adverse effects of azapirones in panic disorder with or without agoraphobia, including general prevalence of adverse effects, compared with placebo.

Search methods: We searched the Cochrane Depression Anxiety and Neurosis Group Trials Specialised Register (CCDANCTR, search date: 10th January 2014), which includes relevant randomised controlled trials from The Cochrane Library (all years), MEDLINE (1950-), EMBASE (1974-), and PsycINFO (1967-).

Selection criteria: Randomised controlled trials that compared azapirones with placebo for panic disorder in adults.

Data collection and analysis: Three review authors independently identified studies, assessed trial quality and extracted data. We contacted study authors for additional information.

Main results: Three studies involving 170 participants compared the azapirone buspirone with placebo. No study provided enough usable information on our primary efficacy outcome (response). For our primary acceptability outcome, moderate-quality evidence indicated that azapirones had lower acceptability than placebo: risk ratio (RR) for dropouts for any reason 2.13 (95% confidence interval (CI) 1.11 to 4.07; 3 studies, 170 participants. Evidence for secondary efficacy outcomes were of low quality. Results on efficacy between azapirone and placebo in terms of agoraphobia (standardised mean difference (SMD) -0.01, 95% CI -0.56 to 0.53; 1 study, 52 participants), general anxiety (mean difference (MD) -2.20, 95% CI -5.45 to 1.06; 2 studies, 115 participants) and depression (MD -1.80, 95% CI -5.60 to 2.00; 1 study, 52 participants) were uncertain. None of the studies provided information for the assessment of allocation concealment or sequence generation. Conflicts of interest were not explicitly expressed. The risk of attrition bias was rated high for all three studies. Information on adverse effects other than dropouts for any reason was insufficient to include in the analyses.

Authors' conclusions: The efficacy of azapirones is uncertain due to the lack of meta-analysable data for the primary outcome and low-quality evidence for secondary efficacy outcomes. A small amount of moderate-quality evidence suggested that the acceptability of azapirones for panic disorder was lower than for placebo. However, only trials of one azapirone (namely buspirone) were included in this review; this, combined with the small sample size, limits our conclusions. If further research is to be conducted, studies with larger sample sizes, with different azapirones and with less risk of bias are necessary to draw firm conclusions regarding azapirones for panic disorder.

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Conflict of interest statement

Hissei Imai: none known.

Aran Tajika: Aran Tajika has received honoraria for speaking at a meeting sponsored by Eli Lilly.

Peiyao Chen: none known.

Giuseppe Guaiana: none known.

Mariasole Castellazzi: none known.

Irene Bighelli: none known.

Francesca Girlanda: none known.

Corrado Barbui: none known.

Markus Koesters: none known.

Andrea Cipriani:none known.

Toshi A Furukawa:Toshi A Furukawa has received honoraria for speaking at CME meetings sponsored by Eli Lilly, Meiji, Mochida, MSD, Pfizer and Tanabe‐Mitsubishi. He is diplomate of the Academy of Cognitive Therapy. He has received royalties from Igaku‐Shoin, Seiwa‐Shoten and Nihon Bunka Kagaku‐sha. He is on advisory board for Sekisui Chemicals and Takeda Science Foundation. The Japanese Ministry of Education, Science, and Technology, the Japanese Ministry of Health, Labor and Welfare, and the Japan Foundation for Neuroscience and Mental Health have funded his research projects.

Figures

1
1
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
1.1
1.1. Analysis
Comparison 1 Azapirone versus placebo, Outcome 1 Dropouts for any reason.
1.2
1.2. Analysis
Comparison 1 Azapirone versus placebo, Outcome 2 Agoraphobia.
1.3
1.3. Analysis
Comparison 1 Azapirone versus placebo, Outcome 3 General anxiety.
1.4
1.4. Analysis
Comparison 1 Azapirone versus placebo, Outcome 4 Depression.
2.1
2.1. Analysis
Comparison 2 Sensitivity analysis: Azapirone versus placebo (excluding studies funded by the pharmaceutical company marketing each azapirone), Outcome 1 Dropouts for any reason.
2.2
2.2. Analysis
Comparison 2 Sensitivity analysis: Azapirone versus placebo (excluding studies funded by the pharmaceutical company marketing each azapirone), Outcome 2 General anxiety.
3.1
3.1. Analysis
Comparison 3 Sensitivity analysis: Azapirone versus placebo ( excluding studies whose participants clearly have significant psychiatric comorbidities), Outcome 1 Dropouts for any reason.
3.2
3.2. Analysis
Comparison 3 Sensitivity analysis: Azapirone versus placebo ( excluding studies whose participants clearly have significant psychiatric comorbidities), Outcome 2 General anxiety.
4.1
4.1. Analysis
Comparison 4 Sensitivity analysis: Azapirone versus placebo (excluding studies with imputed values), Outcome 1 General anxiety.
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References

References to studies included in this review

Pohl 1989 {published data only}
    1. Pohl R, Balon R, Yeragani YK, Gershon S. Serotonergic anxiolytics in the treatment of panic disorder: a controlled study with buspirone. Psychopathology 1989;22(Suppl 1):60‐7. - PubMed
Robinson 1989 {published data only}
    1. Robinson D, Shrotriya RC, Alms DR, Messina M, Andary J. Treatment of panic disorder: nonbenzodiazepine anxiolytics, including buspirone. Psychopharmacology Bulletin 1989;25(1):21‐6. - PubMed
    1. Sheehan D, Raj AB, Sheehan H, Soto S. The relative efficacy of buspirone, imipramine and placebo in panic disorder: a preliminary report. Pharmacology, Biochemistry, and Behavior 1988;29(4):815‐7. - PubMed
    1. Sheehan DV, Raj AB, Sheehan KH, Soto S. Is buspirone effective for panic disorder?. Journal of Clinical Psychopharmacology 1990;10(1):3‐11. - PubMed
Sheehan 1993 {published data only}
    1. Sheehan DV, Raj AB, Harnett‐Sheehan K, Soto S, Knapp E. The relative efficacy of high‐dose buspirone and alprazolam in the treatment of panic disorder: a double‐blind placebo‐controlled study. Acta Psychiatrica Scandinavica 1993;88(1):1‐11. - PubMed

References to studies excluded from this review

Bohm 1990a {published data only}
    1. Bohm C, Robinson DS, Gammans RE, Shrotriya RC, Alms D, Leroy A, et al. Buspirone therapy in anxious elderly patients: a controlled clinical trial. Journal of Clinical Psychopharmacology 1990;10(3 Suppl):47S‐51S. - PubMed
Bohm 1990b {published data only}
    1. Bohm C, Placchi M, Stallone F, Gammans RE, Alms DR, Shrotriya RC, et al. A double‐blind comparison of buspirone, clobazam, and placebo in patients with anxiety treated in a general practice setting. Journal of Clinical Psychopharmacology 1990;10(3 Suppl):38S‐42S. - PubMed
Bouvard 1997 {published data only}
    1. Bouvard M, Mollard E, Guerin J, Cottraux J. Study and course of the psychological profile in 77 patients experiencing panic disorder with agoraphobia after cognitive behaviour therapy with or without buspirone. Psychotherapy and Psychosomatics 1997;66(1):27‐32. - PubMed
Broocks 2002 {published data only}
    1. Broocks A, Bandelow B, Koch K, Bartmann KU, Kinkelbur J, Schweiger U, et al. Smoking modulates neuroendocrine responses to ipsapirone in patients with panic disorder. Neuropsychopharmacology 2002;27(2):270‐8. - PubMed
Broocks 2003 {published data only}
    1. Broocks A, Meyer T, Opitz M, Bartmann U, Hillmer‐Vogel U, George A, et al. 5‐HT1A responsivity in patients with panic disorder before and after treatment with aerobic exercise, clomipramine or placebo. European Neuropsychopharmacology 2003;13(3):153‐64. - PubMed
Bueno 1988 {published data only}
    1. Bueno JR, Laks J. [Atividade ansiolitica da buspirona estudo comparativo com placebo e diazepam]. Journal Brasileiro de Psiquiatria 1988;37(2):97‐9.
Cottraux 1995 {published data only}
    1. Cottraux J, Note ID, Cungi C, Légeron P, Heim F, Chneiweiss L, et al. A controlled study of cognitive behaviour therapy with buspirone or placebo in panic disorder with agoraphobia. British Journal of Psychiatry 1995;167(5):635‐41. - PubMed
Gershon 1982 {published data only}
    1. Gershon S. Drug interactions in controlled clinical trials. Journal of Clinical Psychiatry 1982;43(12):95‐8. - PubMed
Goldberg 1979a {published data only}
    1. Goldberg HL. Buspirone ‐ a new antianxiety agent not chemically related to any presently marketed drugs. Psychopharmacology Bulletin 1979;15(2):90‐2. - PubMed
Goldberg 1979b {published data only}
    1. Goldberg HL, Finnerty R. The comparative efficacy of buspirone and diazepam in the treatment of anxiety. American Journal of Psychiatry 1979;136(9):1184‐7. - PubMed
Goldberg 1982 {published data only}
    1. Goldberg HL, Finnerty R. Comparison of buspirone in two separate studies. Journal of Clinical Psychiatry 1982;12(12 Pt 2):87‐91. - PubMed
Heller 1990 {published data only}
    1. Heller AH, Beneke M, Kuemmel B, Spencer D, Kurtz NM. Ipsapirone: evidence for efficacy in depression. Psychopharmacology Bulletin 1990;26(2):219‐22. - PubMed
Hongbo 1994 {published data only}
    1. Hongbo Z. A clinical comparative trial of buspirone in the treatment of anxiety neurosis. Chinese Journal of Nervous and Mental Disease 1994;20(5):277‐9.
Hua 2002 {published data only}
    1. Hua H, Huaquing M. A comparative study in psychotherapy and drug in teatment of anxiety disorders. Chinese Journal of Nervous and Mental Disorder 1994;28(2):85‐7.
Kai 1992 {published data only}
    1. Kai S, Mizuki Y, Kajimura N, Suetsugi M, Yamada M. Pharmaco‐EEG studies on buspirone, a new anxiolytic drug, in high‐ and low‐anxious humans. Clinical Neuropharmacology 1992;15(Suppl 1):5398.
Klaassen 2002 {published data only}
    1. Klaassen T, Riedel WJ, Praag HM, Menheere P, Griez E. Neuroendocrine response to meta‐chlorophenylpiperazine and ipsapirone in relation to anxiety and aggression. Psychiatry Research 2002;113(1‐2):29‐40. - PubMed
Lee 2005 {published data only}
    1. Lee ST, Park JH, Kim M. Eficacy of the 5‐HT1A agonist, buspirone hydrochloride, in migraineurs with anxiety: a randomized, prospective, parallel group, double‐blind, placebo‐controlled study. Headache 2005;45(8):1004‐11. - PubMed
Lesch 1990 {published data only}
    1. Lesch KP, Mayer S, Disselkamp‐Tietze J, Hoh A, Schoellnhammer G, Schulte HM. Subsensitivity of the 5‐hydroxytryptamine1A (5‐HT1A) receptor‐mediated hypothermic response to ipsapirone in unipolar depression. Life Science 1990;46(18):1271‐7. - PubMed
Lesch 1992 {published data only}
    1. Lesch KP, Wiesmann M, Hoh A, Muller T, Disselkamp‐Tietze J, Osterheider M, Schulte HM. 5‐HT1A receptor‐effector system responsivity in panic disorder. Psychopharmacology 1992;106:111‐117. - PubMed
Mavissakalian 1986 {published data only}
    1. Mavissakalian M, Michelson L. Agoraphobia: relative and combined effectiveness of therapist‐assisted in vivo exposure and imipramine. Journal of Clinical Psychiatry 1986;47(3):117‐22. - PubMed
Miura 1992 {published data only}
    1. Miura S, Asai M, Ito K, Endo S, Ogura C, Kazamatsuri H, et al. Clinical study of buspirone on neurosis ‐ a comparative double‐blind trial with placebo. Clinical Evaluation 1992;19:447‐75.
Murasaki 1992 {published data only}
    1. Murasaki M, Mori A, Endo S, Takemasa K, Hasegawa K, Kamijima K, et al. Late phase III study of a new anxiolytic SM‐3997 (tandospirone) on neurosis. Clinical Evaluation 1992;20:259‐293.
Newton 1982 {published data only}
    1. Newton RE, Casten GP, Alms DR, Benes CO, Marunycz JD. The side effect profile of buspirone in comparison to active controls and placebo. journal of Clinical Psychiatry 1982;43(12 Pt 2):100‐2. - PubMed
Rackel 1990 {published data only}
    1. Rakel RE. Long‐term buspirone therapy for chronic anxiety: a multicenter international study to determine safety. Southern Medical Journal 1990;83(2):194‐7. - PubMed
Rakel 1987 {published data only}
    1. Rakel R. Assessing the efficacy of antianxiety agents. The American Journal of Medicine 1987;82:1‐6. - PubMed
Rickels 1981 {published data only}
    1. Rickels K. Recent advances in anxiolytic therapy. Journal of Clinical Psychiatry 1981;42(11):40‐4. - PubMed
Rickels 2000 {published data only}
    1. Rickels K, DeMartinis N, Garcia‐Espana F, Greenblatt DJ, Mandos LA, Rynn M. Imipramine and buspirone in treatment of patients with generalized anxiety disorder who are discontinuing long‐term benzodiazepine therapy. American Journal of Psychiatry 2000;157(12):1973‐9. - PubMed
Simeon 1994 {published data only}
    1. Simeon J, Knott VJ, Dubois C, Wiggins D, Geraets I, Thatte S, et al. Buspirone therapy of mixed anxiety disorders in childhood and adolescence: a pilot study. Journal of Child and Adolescent Psychopharmacology 1994;4(3):159‐70.
Tyrer 1984 {published data only}
    1. Tyrer P, Owen R. Anxiety in primary care: is short‐term drug treatment appropriate?. Journal of Psychiatry Research 1984;18(1):73‐8. - PubMed
Van Laar 1992 {published data only}
    1. Laar MW, Volkerts ER, Willigenburg AP. Therapeutic effects and effects on actual driving performance of chronically administered buspirone and diazepam in anxious outpatients. Journal of Clinical Psychopharmacology 1992;12(2):86‐95. - PubMed
Zelvelder 1990 {published data only}
    1. Zelvelder WG. Buspirone (Buspar), a double‐blind comparative study of two dosing schedules [Buspirone (Busper); een dubbelblind vergelijkend onderzoek van twee doserings‐schema's]. Journal for Drug Therapy and Research 1990;15(4):112‐8.

Additional references

Als‐Nielsen 2003
    1. Als‐Nielsen B, Chen W, Gluud C, Kjaergard LL. Association of funding and conclusions in randomized drug trials: a reflection of treatment effect or adverse events?. JAMA 2003;290(7):921‐8. - PubMed
Altman 1996
    1. Altman DG, Bland MJ. Detecting skewness for summary information. BMJ 1996;313(7066):1200. - PMC - PubMed
APA 1994
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Arlington, VA: American Psychiatric Publishing, 1994.
APA 2009
    1. American Psychiatric Association. American Psychiatric Association Practice Guidelines for the Treatment of Panic Disorder. American Psychiatric Association Practice Guideline for the Treatment of Panic Disorder. Arlington, VA: American Psychiatric Publishing, 2009.
BAP 2005
    1. Baldwin DS, Anderson IM, Nutt DJ, Bandelow B, Bond A, Davidson JR, et al. Evidence‐based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology 2005;19(6):567‐96. - PubMed
Batelaan 2011
    1. Batelaan NM, Balkom AJ, Stein DJ. Evidence‐based pharmacotherapy of panic disorder: an update. International Journal of Neuropsychopharmacology 2011;15(3):403‐15. [DOI: 10.1017/S1461145711000800] - DOI - PubMed
Bhandari 2004
    1. Bhandari M, Busse JW, Jackowski D, Montori VM, Schünemann H, Sprague S, et al. Association between industry funding and statistically significant pro‐industry findings in medical and surgical randomized trials. Canadian Medical Association Journal 2004;170(4):477‐80. - PMC - PubMed
Bijl 1998
    1. Bijl RV, Ravelli A, Zessen G. Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology 1998;33(12):587‐95. - PubMed
Boissel 1999
    1. Boissel JP, Cucherat M, Li W, Chatellier G, Gueyffier F, Buyse M, et al. The problem of therapeutic efficacy indices. 3. Comparison of the indices and their use [in French]. Therapie 1999;54(4):405‐11. - PubMed
Bruce 2003
    1. Bruce SE, Vasile RG, Goisman RM, Salzman C, Spencer M, Machan JT, et al. Are benzodiazepines still the medication of choice for patients with panic disorder with or without agoraphobia?. American Journal of Psychiatry 2003;160(8):1432‐8. - PubMed
Buchkowsky 2004
    1. Buchkowsky SS, Jewesson PJ. Industry sponsorship and authorship of clinical trials over 20 years. Annals of Pharmacotherapy 2004;38(4):579‐85. - PubMed
Chessick 2006
    1. Chessick CA, Allen MH, Thase ME, Batista Miralha da Cunha AABC, Kapczinski FFK, Silva de Lima M, et al. Azapirones for generalized anxiety disorder. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD006115] - DOI - PMC - PubMed
Cohen 1960
    1. Cohen J. A coefficient of agreement for nominal scales. Educational and Psychological Measurement 1960;20:37‐46.
Deeks 2000
    1. Deeks J. Issues in the selection for meta‐analyses of binary data. Proceedings of the 8th International Cochrane Colloquium; Cape Town, South Africa. 2000 October 25‐28.
Diaz 2011
    1. Diaz MR, Chappell AM, Christian DT, Anderson NJ, McCool BA. Dopamine D3‐like receptors modulate anxiety‐like behavior and regulate GABAergic transmission in the rat lateral/basolateral amygdala. Neuropsychopharmacology 2011;36(5):1090‐103. - PMC - PubMed
Eaton 1994
    1. Eaton WW, Kessler RC, Wittchen HU, Magee WJ. Panic and panic disorder in the United States. American Journal of Psychiatry 1994;151(3):413‐20. - PubMed
Elbourne 2002
    1. Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta‐analyses involving cross‐over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140‐9. - PubMed
Furukawa 2002
    1. Furukawa TA, Guyatt GH, Griffith LE. Can we individualize the 'number needed to treat'? An empirical study of summary effect measures in meta‐analyses. International Journal of Epidemiology 2002;31(1):72‐6. - PubMed
Furukawa 2005
    1. Furukawa TA, Cipriani A, Barbui C, Brambilla P, Watanabe N. Imputing response rates from means and standard deviations in meta‐analysis. International Clinical Psychopharmacology 2005;20(1):49‐52. - PubMed
Furukawa 2006
    1. Furukawa TA, Barbui C, Cipriani A, Brambilla P, Watanabe N. Imputing missing standard deviations in meta‐analyses can provide accurate results. Journal of Clinical Epidemiology 2000;59(1):7‐10. - PubMed
Furukawa 2007
    1. Furukawa TA, Watanabe N, Churchil R. Combined psychotherapy plus antidepressants for panic disorder with or without agoraphobia. Cochrane Database of Systematic Reviews 2007, Issue 1. [DOI: 10.1002/14651858.CD004364.pub2] - DOI - PMC - PubMed
Goisman 1995
    1. Goisman RM, Warshaw MG, Steketee GS, Fierman EJ, Rogers MP, Goldenberg I, et al. DSM‐IV and the disappearance of agoraphobia without a history of panic disorder: new data on a controversial diagnosis. American Journal of Psychiatry 1995;152(10):1438‐43. - PubMed
Gorman 2000
    1. Gorman JM, Kent JM, Sullivan GM, Coplan JD. Neuroanatomical hypothesis of panic disorder, revised. American Journal of Psychiatry 2000;157(4):493‐505. - PubMed
Grant 2006
    1. Grant BF, Hasin DS, Stinson FS, Dawson DA, Goldstein RB, Smith S, et al. The epidemiology of DSM‐IV panic disorder and agoraphobia in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 2006;67(3):363‐74. - PubMed
Guaiana 2013a
    1. Guaiana G, Barbui C, Chiodo D, Cipriani A, Davies SJC, Koesters M. Antidepressants versus placebo for panic disorder in adults. Cochrane Database of Systematic Reviews 2013, Issue 7. [DOI: 10.1002/14651858.CD010676] - DOI - PMC - PubMed
Guaiana 2013b
    1. Guaiana G, Barbui C, Chiodo D, Cipriani A, Davies SJC, Koesters M. Benzodiazepines versus placebo for panic disorder in adults. Cochrane Database of Systematic Reviews 2013, Issue 7. [DOI: 10.1002/14651858.CD010677] - DOI - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org. J.
Kessler 2006
    1. Kessler RC, Chiu WT, Jin R, Ruscio AM, Shear K, Walters EE. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Archives of General Psychiatry 2006;63(4):415‐24. - PMC - PubMed
King 2008
    1. King M, Nazareth I, Levy G, Walker C, Morris R, Weich S, et al. Prevalence of common mental disorders in general practice attendees across Europe. British Journal of Psychiatry 2008;192(5):362‐7. - PubMed
Kishi 2013
    1. Kishi T, Meltzer Y, Iwata N. Augmentation of antipsychotic drug action by azapirone 5‐HT1A receptor partial agonists: a meta‐analysis. International Journal of Neuropsychopharmacology 2013;16(6):1259‐66. - PubMed
Klein 1964
    1. Klein DF. Delineation of two drug‐responsive anxiety syndromes. Psychopharmacologia 1964;5:397‐408. - PubMed
Lexchin 2003
    1. Lexchin J, Bero LA, Djulbegovic B, Clark O. Pharmaceutical industry sponsorship and research outcome and quality: systematic review. British Medical Journal 2003;326(7400):1167‐70. - PMC - PubMed
Moher 2009
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA group. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses: The PRISMA Statement. PLOS Medicine 2009;6(6):e1000097. - PMC - PubMed
Napoliello 1991
    1. Napoliello MJ, Domantay AG. Buspirone: a worldwide update. British Journal of Psychiatry 1991;159(Suppl 12):40‐4. - PubMed
Nash 2008
    1. Nash JR, Sargent PA, Rabiner EA, Hood SD, Argyropoulos SV, Potokar JP, et al. Serotonin 5‐HT1A receptor binding in people with panic disorder: positron emission tomography study. British Journal of Psychiatry 2008;193(3):229‐34. - PubMed
Neumeister 2004
    1. Neumeister A, Bain E, Nugent AC, Carson RE, Bonne O, Luckenbaugh DA, et al. Reduced serotonin type 1A receptor binding in panic disorder. Journal of Neuroscience 2004;24(3):589‐91. - PMC - PubMed
NICE 2011
    1. National Institute for Health and Clinical Excellence. Generalised Anxiety Disorder and Panic Disorder (With or Without Agoraphobia) in Adults [CG113]. London: National Institute for Health and Clinical Excellence, 2011.
Parks 1998
    1. Parks CL, Robinson PS, Sibille E, Shenk T, Toth M. Increased anxiety of mice lacking the serotonin1A receptor. Proceedings of the National Academy of Sciences of the United States of America 1998;95(18):10734–9. - PMC - PubMed
Payer 2013
    1. Payer D, Bolleau I, Guranda M, Graff A, Nakajima S, Meyer J, et al. Buspirone occupancy of D2/3 dopamine receptors in humans measured by positron emission tomography. Proceedings of the College on Problems of Drug Dependence, 75th Annual Scientific Meeting, San Diego, CA. 15‐20 June 2013.
Pompoli 2013
    1. Pompoli A, Furukawa TA, Imai H, Tajika A, Efthimiou O, Salanti G. Psychological therapies for panic disorder with or without agoraphobia in adults. Cochrane Database of Systematic Reviews 2014, Issue 2. [DOI: 10.1002/14651858.CD011004] - DOI - PMC - PubMed
Sheehan 1988
    1. Sheehan D, Raj AB, Sheehan H, Soto S. The relative efficacy of buspirone, imipramine and placebo in panic disorder: a preliminary report. Pharmacology, Biochemistry, and Behavior 1988;29(4):815‐7. - PubMed
Sheehan 1990
    1. Sheehan DV, Raj AB, Sheehan KH, Soto S. Is buspirone effective for panic disorder?. Journal of Clinical Psychopharmacology 1990;10(1):3‐11. - PubMed
Starcevic 2009
    1. Starcevic V. Anxiety Disorders in Adults: A Clinical Guide. Oxford, UK: Oxford University Press, 2009.
Stein 2010
    1. Stein M, Steckler T, Lightfoot JD, Hay E, Goddard AW. Pharmacologic treatment of panic disorder. Current Topics in Behavioral Neurosciences 2010;2:469‐85. - PubMed
Tauscher 2001
    1. Tauscher J, Bagby RM, Javanmard M, Christensen BK, Kasper S, Kapur S. Inverse relationship between serotonin 5‐HT(1A) receptor binding and anxiety: a [(11)C]WAY‐100635 PET investigation in healthy volunteers. American Journal of Psychiatry 2001;158(8):1326‐8. - PubMed
Wade 1999
    1. Wade AG. Antidepressants in panic disorder. International Clinical Psychopharmacology 1999;14(Suppl 2):13‐7. - PubMed
Watanabe 2009
    1. Watanabe N, Churchill R, Furukawa TA. Combined psychotherapy plus benzodiazepines for panic disorder. Cochrane Database of Systematic Reviews 2009, Issue 1. [DOI: 10.1002/14651858.CD005335.pub2] - DOI - PubMed

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