Drug Treatment of Panic Disorder

The February 1992 issue of the British Journal of Psychiatry contained the summary report from the Second Phase of the Cross-National Collaborative Panic Study (CNCPS) on a clinical treatment trial of panic disorder. This manuscript was submitted in 1988 and took four years of response to critiques and revisions to generate a manuscript that was acceptable to the Editor of the British Journal of Psychiatry. In the same issue, Marks et al (1992) provided a ‘Comment’ which was critical of the study, calling it an “elephantine labour” which “resulted in the delivery of a mouse” and was highly critical of the statistical analyses and interpretation. Moreover, their ‘Comment’ was a springboard for discussing general issues in the treatment of panic disorder and the relative value of pharmacological versus psychological treatments. In our opinion, the Marks et al ‘Comment’ is inaccurate and misleading. At many points, they make reference to topics being missing that are actually addressed to our manuscript and they presented a statistical summary in Table 1 (p. 203) of our data which was inaccurate. In this Comment, we address each item criticised.