Paroxetine , sertraline , citalopram , escitalopram , and clomipramine showed the most consistent results , while fluvoxamine , fluoxetine , and imipramine showed limited efficacy .
Preliminary results suggested the potential efficacy of inositol ; D-cycloserine showed mixed results for its ability to improve the outcome of exposure-based cognitive behavioral therapy .
No studies have been specifically oriented toward evaluating the effect of drugs on AG ; in the available studies , the improvement of AG might have been the consequence of the reduction of panic attacks .
BACKGROUND Although there are controversial issues ( the " American view " and the " European view " ) regarding the construct and definition of agoraphobia ( AG ) , this syndrome is well recognized and it is a burden in the lives of millions of people worldwide .
To better clarify the role of drug therapy in AG , the authors summarized and discussed recent evidence on pharmacological treatments , based on clinical trials available from 2000 , with the aim of highlighting pharmacotherapies that may improve this complex syndrome .
A randomized trial of cognitive-behavioral therapy or selective serotonin reuptake inhibitor or both combined for panic disorder with or without agoraphobia: treatment results through 1-year follow-up.
OBJECTIVE To establish the long-term effectiveness of 3 treatments for DSM-IV panic disorder with or without agoraphobia :  cognitive-behavioral therapy ( CBT ) , pharmacotherapy using a selective serotonin reuptake inhibitor ( SSRI ) , or the combination of both ( CBT + SSRI ) . As a secondary objective , the relationship between treatment outcome and 7 predictor variables was investigated . METHOD Patients were enrolled between April 2001 and September 2003 and were r and omly assigned to treatment . Academic and nonacademic clinical sites participated . Each treatment modality lasted 1 year . Pharmacotherapists were free to choose between 5 SSRIs currently marketed in The Netherl and s. Outcome was assessed after 9 months of treatment ( posttest 1 ) , after discontinuation of treatment ( posttest 2 ) , and 6 and 12 months after treatment discontinuation ( follow-up 1 and follow-up 2 ) . RESULTS In the sample ( N = 150 ) , 48 % did not suffer from agoraphobia or suffered from only mild agoraphobia , while 52 % suffered from moderate or severe agoraphobia . Patients in each treatment group improved significantly from pretest to posttest 1 on the primary outcome measures of level of anxiety ( P < .001 ) , degree of coping ( P < .001 ) , and remitter status ( P < .001 ) , as well as on the secondary outcome measures of depressive symptomatology ( P < .001 ) , and from pretest to posttest 2 for health-related quality of life ( P < .001 ) . Gains were preserved from posttest 2 throughout the follow-up period . Some superiority of CBT + SSRI and SSRI as compared with CBT was observed at posttest 1 . However , at both follow-ups , differences between treatment modalities proved nonsignificant . Client satisfaction appeared to be high at treatment endpoint , while patients receiving CBT + SSRI appeared slightly ( P < .05 ) more satisfied than those receiving CBT only . CONCLUSIONS No fall-off in gains was observed for either treatment modality after treatment discontinuation . SSRIs were associated with adverse events . Gains produced by CBT were slower to emerge than those produced by CBT + SSRI and SSRI , but CBT ended sooner . TRIAL REGISTRATION Netherl and s Trial Register ( www.trialregister.nl ) Identifier : IS RCT N8156869
Paroxetine , sertraline , citalopram , escitalopram , and clomipramine showed the most consistent results , while fluvoxamine , fluoxetine , and imipramine showed limited efficacy .
Preliminary results suggested the potential efficacy of inositol ; D-cycloserine showed mixed results for its ability to improve the outcome of exposure-based cognitive behavioral therapy .
No studies have been specifically oriented toward evaluating the effect of drugs on AG ; in the available studies , the improvement of AG might have been the consequence of the reduction of panic attacks .
BACKGROUND Although there are controversial issues ( the " American view " and the " European view " ) regarding the construct and definition of agoraphobia ( AG ) , this syndrome is well recognized and it is a burden in the lives of millions of people worldwide .
To better clarify the role of drug therapy in AG , the authors summarized and discussed recent evidence on pharmacological treatments , based on clinical trials available from 2000 , with the aim of highlighting pharmacotherapies that may improve this complex syndrome .