Comparing Selective Serotonin Reuptake Inhibitors (SSRIs) Alone and in Combination With Beta-Blockers for Treating Panic Disorders: A Prospective Cohort Study.

Autor:	Bajabir D; Psychiatry, Medical Cities Program, Ministry of Interior, Riyadh, SAU., Alsubhi A; Medicine, Umm Al-Qura University, Makkah, SAU., Felimban SA; Medicine, Umm Al-Qura University, Makkah, SAU., Alotaibi RZ; Medicine and Surgery, Umm Al-Qura University, Makkah, SAU., Almalki A; Medicine and Surgery, Umm Al-Qura University, Makkah, SAU., Allahyani NS; Psychiatry, Umm Al-Qura University, Makkah, SAU., Yaseen RY; Psychiatry, Umm Al-Qura University, Makkah, SAU., Kofiah FB; Psychiatry, Umm Al-Qura University, Makkah, SAU., Almatrafi AA; Medicine and Surgery, Umm Al-Qura University, Al-Qunfudah, SAU., Alzahrani SA; Preventive Medicine, Ministry of National Guard Health Affairs, Jeddah, SAU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 07; Vol. 16 (9), pp. e68862. Date of Electronic Publication: 2024 Sep 07 (Print Publication: 2024).
DOI:	10.7759/cureus.68862
Abstrakt:	Background Panic disorders are prevalent psychiatric conditions affecting 1.6% to 2.2% of the global population. While selective serotonin reuptake inhibitors (SSRIs) are the first line of treatment, their initial exacerbation of symptoms presents challenges. Beta-blockers have shown promise in managing panic symptoms, but research comparing the efficacy of combined SSRI and beta-blocker therapy to SSRI monotherapy is limited, particularly in Saudi Arabia. Objective To assess the effectiveness of SSRIs combined with beta-blockers vs. SSRI monotherapy in improving panic disorder symptoms severity in patients at King Abdul-Aziz Hospital, Makkah, Saudi Arabia. Methods This prospective cohort study included 62 patients with panic disorder, divided into two groups: SSRI monotherapy (n=29) and SSRIs with beta-blockers (n=33). Panic disorder severity was assessed using the Panic Disorder Severity Scale (PDSS) after three months of treatment. Secondary outcomes included depression and anxiety symptoms, measured by the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder Scale (GAD-7), respectively. Statistical analysis involved Mann-Whitney U tests for comparing PDSS scores between the groups due to non-parametric distribution and Chi-square tests for categorical variables. Relative risks (RR) were calculated to assess the likelihood of abnormal PDSS, PHQ-9, and GAD-7 scores between the groups. Multivariable linear regression was used to adjust for potential confounding factors. Results No statistically significant difference in PDSS scores was found between SSRI monotherapy (median=6, interquartile range (IQR)=3-9) and combination therapy (median=8, IQR=3-13) groups (p=0.188). The relative risk of abnormal PDSS scores was 1.8 times higher in the combination therapy group (p=0.077). No significant differences in depression (p=0.386) or anxiety (p=0.182) symptoms were observed. Additionally, 66.7% of combination therapy patients had abnormal PDSS scores compared to 33.3% in the SSRI group. The mean PHQ-9 score was 11.08±6.93, and the mean GAD-7 score was 10.69±6.41 for the total sample. Conclusion This study found no significant difference in the effectiveness of SSRIs combined with beta-blockers vs. SSRI monotherapy for treating panic disorders. However, the trend towards higher PDSS scores in the combination therapy group suggests further investigation is needed. Study limitations included small sample size, single-center design, short follow-up period, and lack of randomization. Despite these, the study provided valuable insights into treatment approaches for panic disorders in the Saudi population. Larger, randomized controlled trials with longer follow-up periods and multi-center designs are recommended for future research. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Directorate of Health Affairs, Ministry of Health issued approval H-02-K-076-0123-886. Ethical approval was obtained from the Institutional Review Board (IRB) of the Directorate of Health Affairs, Makkah, affiliated with the Ministry of Health, Saudi Arabia. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Bajabir et al.)
Databáze:	MEDLINE
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