Sibutramine and Panic Attacks

Ms. A, a 62-year-old woman, had been diagnosed as having panic attacks during her mid-20s and had been initially treated with anxiolytics. She had been panic-free without treatment since her mid-30s, except for two attacks, both of which had occurred after minor surgical procedures.

Ms. A started taking sibutramine, 10 mg/day, for weight loss. After 1½ weeks of taking sibutramine, she had two panic attacks in rapid succession. She discontinued the medication for several days and had no further attacks. She then restarted sibutramine and had another panic attack within approximately 3 days. She again discontinued sibutramine and has been asymptomatic for 5 months. Ms. A declined a third exposure to sibutramine. She was not unduly apprehensive about taking medication, and there were no obvious psychological stressors present at the time.