Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia.

Abstract

OBJECTIVE:

To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono-treatments.

METHOD:

Patients with PD (n = 150) with or without agoraphobia received CBT, SSRI or CBT + SSRI. Outcome was assessed after 9 months, before medication taper.

RESULTS:

CBT + SSRI was clearly superior to CBT in both completer and intent-to-treat analysis (ITT). Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT + SSRI and SSRI.

CONCLUSION:

Both the mono-treatments (CBT and SSRI) and the combined treatment (CBT + SSRI) proved to be effective treatments for PD. At post-test, CBT + SSRI was clearly superior to CBT, but differences between CBT + SSRI and SSRI, and between SSRI and CBT, were small.

• Authors: F J van Apeldoorn, W J P J van Hout, P P A Mersch, M Huisman, B R Slaap, W W Hale 3rd, S Visser, R van Dyck, J A den Boer
• Journal: Acta psychiatrica Scandinavica (Acta Psychiatr Scand) Vol. 117 Issue 4 Pg. 260-70 (Apr 2008) ISSN: 1600-0447 [Electronic] United States
• PMID: 18307586 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Serotonin Uptake Inhibitors

Topics

• Adolescent
• Adult
• Agoraphobia (drug therapy, therapy)
• Anxiety Disorders (diagnosis, therapy)
• Cognitive Behavioral Therapy (methods)
• Combined Modality Therapy
• Female
• Humans
• Male
• Middle Aged
• Panic Disorder (diagnosis, drug therapy, therapy)
• Selective Serotonin Reuptake Inhibitors (therapeutic use)
• Severity of Illness Index
• Surveys and Questionnaires
• Treatment Outcome