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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Snowie on July 30, 2000, at 7:39:12
Anybody hear of Pagoclone, a new drug under development by Interneuron Pharmaceuticals for treating panic disorder and GAD? Any info is appreciated!
Snowie
Posted by Sunnely on July 30, 2000, at 19:53:00
In reply to Pagoclone--Cam, Sunnely, or Anyone?, posted by Snowie on July 30, 2000, at 7:39:12
> Anybody hear of Pagoclone, a new drug under development by Interneuron Pharmaceuticals for treating panic disorder and GAD? Any info is appreciated!
>
> SnowieAllow me to share my 2 cents. This info was from a psychopharm newsletter from 1998. It may not be the latest news but I think still newsworthy, nonetheless.
As you have mentioned, pagoclone is a new drug under development by Interneuron Pharmaceuticals, Lexington, Mass, for treating panic disorder and GAD. It works by increasing the function of the major inhibitory neurotransmitter (brain chemical) GABA (gamma aminobutyric acid). Panic disorder is believed to be associated with excessive nerve activity caused by a decrease in GABA function. Pagaclone is a partial agonist at a modulatory site on the GABA receptor, which enhances the action of GABA in the brain. That effect reduces excessive nerve activity associated with anxiety and panic attacks. (Partial agonists are a group of drugs that have a mixture of agonist [pro] and antagonist [against] properties. They act as agonists in the face of neurotransmitter deficiency and antagonists in the face of neurotransmitter excess.)
A two-week pilot study of pagoclone was conducted (a couple years ago) in 16 patients with panic disorder in the U.K. These patients experienced 2 to 10 panic attacks per week in the two weeks prior to enrolment. Patients were randomly assigned to receive either 0.1 mg of pagoclone 3 times daily or placebo for 2 weeks. All patients received placebo during a wash-out period in week 3, and in weeks 4 and 5, patients who had initially received pagoclone received placebo and vice-versa. During week 6, there was a final wash-out period. Outcome measurements included change in the number of full and partial panic attacks, withdrawal, and rebound anxiety symptoms.
Pagoclone produced a significant reduction in the total number of panic attacks (40%) over a two-week period. Patients also experienced a 40% reduction in the number of panic attacks per day compared to the pre-treatment period. There was no significant change in the total number of panic attacks during placebo treatment. Patients did not experience sedation, withdrawal or rebound anxiety effects, which are common with benzodiazepine drugs often used to treat panic disorder.
Investigators concluded that the results of the study provide clinical support for the hypothesis that the administration of pagoclone is of significant benefit in panic disorder. They were encouraged by the rapid onset of action seen among patients in this study as well as by the absence of sedative effects and withdrawal symptoms. They suggested that it might have same speed of onset as drugs such as alprazolam (Xanax) but with fewer problems such as sedation, unsteadiness, and withdrawal.
The director of clinical research at Interneuron Pharmaceuticals indicates that if further pagoclone trials prove promising, it will be superior to treatments for panic disorder such as benzodiazepines, buspirone (BuSpar), and antidepressants. Benzodiazepines can't be used long-term because of their addictive qualities, and buspirone isn't effective in all panic disorder patients. Tricyclic antidepressants have unwanted side effects such as sedation, and selective serotonin reuptake inhibitors (SSRIs) can take time to become effective.
The director of research believes that pagoclone will be indicated for generalized anxiety disorder (GAD), depending on results of further studies. A phase 2/3 dosing study is currently underway to compare the effects of three doses of pagoclone to placebo during a 10-week period in 280 patients. Primary outcome measures will include the frequency of panic attacks experienced by patients. The study is expected to be completed in 1999; approval of the drug in the US could occur as soon as 2000.
Posted by Snowie on July 30, 2000, at 21:06:00
In reply to Re: Pagoclone--Cam, Sunnely, or Anyone?, posted by Sunnely on July 30, 2000, at 19:53:00
Thanks, Sunnely. I was hoping you could shed some light on this promising new drug. I had heard years ago that there was a new drug being tested for GAD/panic disorder that works on the GABA neurotransmitter.
Any idea as to when Pagoclone might be ready for use in the USA? Obviously, the end of year 2000 is not far away, and I would be anxious to try this drug. Do you have any gut feelings about it so far? I doubt anything will eliminate or replace the benzos entirely, but it sure would be great to have other options for treating my GAD, which if left untreated results in agoraphobia and an occasional panic attack. I tried BuSpar once and was disappointed with the results. Xanax is my drug of choice these days. I briefly tried generic Klonopin ... don't even get me started about that.
Thanks for your time and interest ... you write similarly to someone else I know. ;-) S/he is quite knowledgeable as well. It's a pleasure having you on this Board.
Snowie
Posted by SadSuzie on July 31, 2000, at 15:01:11
In reply to Pagoclone--Cam, Sunnely, or Anyone?, posted by Snowie on July 30, 2000, at 7:39:12
Look here for more information:
http://www.interneuron.com/news/12_27_99.htm
> Anybody hear of Pagoclone, a new drug under development by Interneuron Pharmaceuticals for treating panic disorder and GAD? Any info is appreciated!
>
> Snowie
Posted by Snowie on July 31, 2000, at 17:31:54
In reply to Re: Pagoclone--Cam, Sunnely, or Anyone?, posted by SadSuzie on July 31, 2000, at 15:01:11
SadSuzie,
Thanks so much for that link!!! I'm can hardly wait to try this new med!
Snowie
Posted by yona on August 3, 2000, at 6:51:39
In reply to Re: Pagoclone--Cam, Sunnely, or Anyone? » SadSuzie, posted by Snowie on July 31, 2000, at 17:31:54
i am interested in this drug too. does anyone know if it is available yet?? has anyone done any drug trials? the link above was good but no mention of a time frame. thanks for your help. yo
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