The second week of panic attacks completely stopped.

 Prior to Paxil scale HAMD defined "low depressive episode" (15 points), the MARDS - clinically minor depression ", according to BDI - easy." The second week of panic attacks completely stopped. Analysis of the dynamics of individual groups of signs for the HAMD, timoleptichesky characterize the effect of Paxil (signs 1, 2,3), its stimulatory (signs 7, 8) and sedative (anxiolytic) effect (signs 9,10), in this case identifies the leading self timolepticheskoe action Paxil in the initial stages of treatment. Reduction of symptoms, reflecting gipotimiyu the end of 1 week reached 68.7%, whereas the activating effect of the drug is uniformly grew to 21 days (the degree of reduction of the corresponding signs of depression HAMD - 64%). Anxiolytic effect of Paxil grew slower normotimicheskogo, but was noticeably more stable. Severity of anxiety has decreased by 23% NAMA (from 22.9 to 17.6 points) at the end of the first week and 71.2% compared with baseline (up to 6.7 points). Clinically it is manifested by relief of somatic anxiety, restlessness, normalization of sleep and appetite, decrease in hypochondriacal fixation on sinestepatiyah in the first days of therapy. In a subsequent slowing of the noted, shortening and osloblenie intensity of paroxysms of anxiety and fear of them. Sedation peaked and remained at this level until the end of therapy, as judged by the absence of panic attacks in a patient after patient treatment. In general, there is renewed interest, increased motor activity, expansion of the range of positive emotional reactions, taking care of the family, the emergence of plans for the future, the formation of labor units. Efficiency and mental activity (a sign of 7 to HAMD) recovered by the end of the 2 nd month of therapy at 86,8%. In general, drug-tolerated without subjective discomfort. There were no daytime drowsiness, dry mouth, dysuria, and other side effects typical of classical antidepressants, because of the selective serotoninergic action of paroxetine. On a scale of SARS severity of such side effects as nausea, dizzy, short-term sleep at night was equal to 1 point and did not require a change in regimens. Thus, the psychotropic activity of Paxil characterized by a combination of timolepticheskogo with activating by apathetic depression and sedation with azhitirovanyh states. When the clinical picture of the affect of anxiety prevails in the action shall anxiolytic component, whose intensity increases in accordance with the duration of therapy. With the dominance of psycho-motor retardation, becomes significant stimulatory effect at a dose of Paxil, an adequate depth of the existing depression. "Balancing" property of paroxetine significantly expands the range of indications for its use. Anxiolytic effect of Paxil for panic disorder can reduce the usual dose of tranquilizers used in relieving anxiety and reduce the likelihood of getting used to them.