Abstract | BACKGROUND: Both cognitive-behavioral therapy and treatment with selective serotonin reuptake inhibitors ( SSRIs) have proved to be effective in the treatment of panic disorder. The present study examined the effects of paroxetine added to continued cognitive-behavioral therapy in patients who were unsuccessfully treated with initial cognitive-behavioral therapy alone. METHOD: 161 patients with panic disorder with or without agoraphobia (DSM-IV criteria) underwent a manual-guided cognitive-behavioral therapy of 15 sessions. Forty-three unsuccessfully treated patients from this group were included in a double-blind, placebo-controlled, next-step treatment study consisting of continued cognitive-behavioral therapy plus adjunctive paroxetine at a dose of 40 mg/day or continued cognitive-behavioral therapy plus placebo. RESULTS: Overall, patients in the cognitive-behavioral therapy plus paroxetine condition improved significantly on agoraphobic behavior (p < .05) and anxiety discomfort (p < .01), whereas patients in the cognitive-behavioral therapy plus placebo condition did not. Effect sizes in the cognitive-behavioral therapy plus paroxetine condition ranged from 1.0 to 1.8 and in the cognitive-behavioral therapy plus placebo condition, from 0.4 to 1.0. CONCLUSION: Patients with panic disorder who are unsuccessfully treated with initial cognitive-behavioral therapy may benefit from the addition of an SSRI as a second treatment modality. The importance of timely evaluation of treatment results is emphasized.
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Authors | Mirjam Kampman, Ger P J Keijsers, Cees A L Hoogduin, Gert-Jan Hendriks |
Journal | The Journal of clinical psychiatry
(J Clin Psychiatry)
Vol. 63
Issue 9
Pg. 772-7
(Sep 2002)
ISSN: 0160-6689 [Print] United States |
PMID | 12363116
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Placebos
- Serotonin Uptake Inhibitors
- Paroxetine
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Topics |
- Agoraphobia
(drug therapy, psychology, therapy)
- Cognitive Behavioral Therapy
(methods)
- Combined Modality Therapy
- Double-Blind Method
- Drug Administration Schedule
- Humans
- Panic Disorder
(drug therapy, psychology, therapy)
- Paroxetine
(therapeutic use)
- Personality Inventory
- Placebos
- Selective Serotonin Reuptake Inhibitors
(therapeutic use)
- Surveys and Questionnaires
- Treatment Outcome
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