After the acute phase treatment , as long as the drug was continued , the superiority of the combination over either monotherapy appeared to persist .
BACKGROUND Panic disorder can be treated with pharmacotherapy , psychotherapy or in combination , but the relative merits of combined therapy have not been well established .
OBJECTIVES To review evidence concerning short- and long-term advantages and disadvantages of combined psychotherapy plus antidepressant treatment for panic disorder with or without agoraphobia , in comparison with either therapy alone .
Autonomic changes after treatment of agoraphobia with panic attacks
Twenty-three patients meeting DSM-III criteria for agoraphobia with panic attacks and 14 age- , race- , and sex-matched nonanxious controls were tested in the laboratory and on a test walk in a shopping mall . The patients were tested before and after about 15 weeks of treatment with placebo and exposure therapy , imipramine and exposure therapy , or imipramine and initial antiexposure instructions . Controls were tested twice at a similar interval , but without any treatment . On test day 1 , patients compared to controls showed higher average heart rate and skin conductance levels and greater numbers of skin conductance fluctuations in the laboratory , and higher heart rates before and during the test walk . Between pretreatment and posttreatment tests , clinical ratings improved and skin conductance levels decreased in all treatment groups . Heart rate levels in the laboratory , on the other h and , decreased in patients on placebo and rose in patients on imipramine . Thus , imipramine compromises the usefulness of heart rate as a measure of emotional arousal . Higher pretreatment heart rates predicted greater clinical improvement
After the acute phase treatment , as long as the drug was continued , the superiority of the combination over either monotherapy appeared to persist .
BACKGROUND Panic disorder can be treated with pharmacotherapy , psychotherapy or in combination , but the relative merits of combined therapy have not been well established .
OBJECTIVES To review evidence concerning short- and long-term advantages and disadvantages of combined psychotherapy plus antidepressant treatment for panic disorder with or without agoraphobia , in comparison with either therapy alone .