Duloxetine in panic disorder with somatic gastric pain

Matteo Preve,1 Cristiana Nisita,1 Massimo Bellini,2 Liliana Dell'Osso1 1Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, 2Department of Gastroenterology, Gastrointestinal Unit, University of Pisa, Pisa, Italy Abstract: Panic disorder is the most common type of anxiety...

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Autores principales:	Preve M, Nisita C, Bellini M, Dell&#39;Osso L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/2cd1d585d8484d0a8248a716598fd038
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spelling	oai:doaj.org-article:2cd1d585d8484d0a8248a716598fd0382021-12-02T06:25:16ZDuloxetine in panic disorder with somatic gastric pain1176-63281178-2021https://doaj.org/article/2cd1d585d8484d0a8248a716598fd0382013-11-01T00:00:00Zhttp://www.dovepress.com/duloxetine-in-panic-disorder-with-somatic-gastric-pain-a15040https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Matteo Preve,1 Cristiana Nisita,1 Massimo Bellini,2 Liliana Dell'Osso1 1Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, 2Department of Gastroenterology, Gastrointestinal Unit, University of Pisa, Pisa, Italy Abstract: Panic disorder is the most common type of anxiety disorder, and its most common expression is panic attacks characterized with sudden attacks of anxiety with numerous symptoms, including palpitations, tachycardia, tachypnea, nausea, and vertigo: ie, cardiovascular, gastroenterologic, respiratory, and neuro-otologic symptoms. In clinical practice, panic disorder manifests with isolated gastroenteric or cardiovascular symptoms, requiring additional clinical visits after psychiatric intervention. The first-line treatment for anxiety disorders, and in particular for panic disorder, is the selective serotonin reuptake inhibitors. However, these drugs can have adverse effects, including sexual dysfunction, increased bodyweight, and abnormal bleeding, that may be problematic for some patients. Here we report the case of a 29-year-old Caucasian woman affected by panic disorder with agoraphobia who was referred to our clinic for recurrent gastroenteric panic symptoms. The patient reported improvement in her anxiety symptoms and panic attacks while on a selective serotonin reuptake inhibitor, but not in her gastric somatic problems, so the decision was taken to start her on duloxetine, a serotonin-norepinephrine reuptake inhibitor. After 6 months of treatment, the patient achieved complete remission of her gastric and panic-related symptoms, and was able to stop triple gastric therapy. Other authors have hypothesized and confirmed that duloxetine has greater initial noradrenergic effects than venlafaxine and is effective in patients with panic disorder. This case report underscores the possibility of tailoring therapeutic strategies for the gastroenteric expression of panic disorder. Keywords: anxiety disorder, panic attacks, palpitations, tachycardia, tachypnea, nausea, vertigoPreve MNisita CBellini MDell&#39;Osso LDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2013, Iss default, Pp 1811-1813 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Preve M Nisita C Bellini M Dell&#39;Osso L Duloxetine in panic disorder with somatic gastric pain
description	Matteo Preve,1 Cristiana Nisita,1 Massimo Bellini,2 Liliana Dell'Osso1 1Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, 2Department of Gastroenterology, Gastrointestinal Unit, University of Pisa, Pisa, Italy Abstract: Panic disorder is the most common type of anxiety disorder, and its most common expression is panic attacks characterized with sudden attacks of anxiety with numerous symptoms, including palpitations, tachycardia, tachypnea, nausea, and vertigo: ie, cardiovascular, gastroenterologic, respiratory, and neuro-otologic symptoms. In clinical practice, panic disorder manifests with isolated gastroenteric or cardiovascular symptoms, requiring additional clinical visits after psychiatric intervention. The first-line treatment for anxiety disorders, and in particular for panic disorder, is the selective serotonin reuptake inhibitors. However, these drugs can have adverse effects, including sexual dysfunction, increased bodyweight, and abnormal bleeding, that may be problematic for some patients. Here we report the case of a 29-year-old Caucasian woman affected by panic disorder with agoraphobia who was referred to our clinic for recurrent gastroenteric panic symptoms. The patient reported improvement in her anxiety symptoms and panic attacks while on a selective serotonin reuptake inhibitor, but not in her gastric somatic problems, so the decision was taken to start her on duloxetine, a serotonin-norepinephrine reuptake inhibitor. After 6 months of treatment, the patient achieved complete remission of her gastric and panic-related symptoms, and was able to stop triple gastric therapy. Other authors have hypothesized and confirmed that duloxetine has greater initial noradrenergic effects than venlafaxine and is effective in patients with panic disorder. This case report underscores the possibility of tailoring therapeutic strategies for the gastroenteric expression of panic disorder. Keywords: anxiety disorder, panic attacks, palpitations, tachycardia, tachypnea, nausea, vertigo
format	article
author	Preve M Nisita C Bellini M Dell&#39;Osso L
author_facet	Preve M Nisita C Bellini M Dell&#39;Osso L
author_sort	Preve M
title	Duloxetine in panic disorder with somatic gastric pain
title_short	Duloxetine in panic disorder with somatic gastric pain
title_full	Duloxetine in panic disorder with somatic gastric pain
title_fullStr	Duloxetine in panic disorder with somatic gastric pain
title_full_unstemmed	Duloxetine in panic disorder with somatic gastric pain
title_sort	duloxetine in panic disorder with somatic gastric pain
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/2cd1d585d8484d0a8248a716598fd038
work_keys_str_mv	AT prevem duloxetineinpanicdisorderwithsomaticgastricpain AT nisitac duloxetineinpanicdisorderwithsomaticgastricpain AT bellinim duloxetineinpanicdisorderwithsomaticgastricpain AT dellamp39ossol duloxetineinpanicdisorderwithsomaticgastricpain
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Duloxetine in panic disorder with somatic gastric pain

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