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 .
Behavior therapy, supportive psychotherapy, imipramine, and phobias.
In a controlled outcome study of phobias , 111 adult patients ( 69 % women , 31 % men ) received a course of 26 weekly treatment sessions consisting of ( 1 ) behavior therapy and imipramine hydrochloride ( 2 ) behavior therapy and placebo , or ( 3 ) supportive psychotherapy and imipramine .  Patients were classified as agoraphobic , mixed phobic , or simple phobic . The great majority of patients in all groups showed moderate to marked global improvement ( 70 % to 86 % , depending on rater ) . In agoraphobics and mixed phobics ( both groups experiencing spontaneous panic attacks ) , imipramine was significantly superior to placebo . There was no difference between behavior therapy and supportive therapy , both result ing in high improvement rates ( 76 % to 100 % , depending on rater ) . In simple phobic patients , there was a high rate of improvement with all treatment regimens ( 72 % to 93 % , depending on rater ) , with no significant difference between imipramine and placebo or between behavior therapy and supportive therapy . Of 88 moderately to markedly improved patients followed up for one year after completing treatment , 83 % maintained their gains and 17 % relapsed . No patients showed symptom substitution . Eighteen percent of the patients receiving imipramine hydrochloride showed marked stimulant side effects on from 5 to 75 mg/day
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 .