Therapy for panic disorder that includes both cognitive behavioral therapy (CBT) and medication is more effective than medications alone, according to a study published in Archives of General Psychiatry.
Panic disorder is one of the most disabling anxiety disorders and is commonly treated with medications alone in primary care settings. This well controlled study assessed whether "evidence-based, specialist-delivered panic disorder interventions" could be generalized to primary care settings with non-specialist therapists and more diverse patient populations.
232 primary-care patients in Seattle meeting the DSM-IV criteria for panic disorder were assigned to receive treatment as usual (medication and counseling from the physician on recognition and treatment of panic disorder) or to receive an intervention consisting of up to six sessions in the course of three months of CBT, with up to six follow-up telephone contacts during the next nine months, along with medications.
According to the authors Patients who received CBT and medications did better than patients who received the usual treatment. The proportion of CBT and medication patients whose symptoms improved significantly was higher than those receiving usual care after three months and after one year. The patients receiving the CBT and medication intervention also made significantly greater improvements on two standard measures of mental health functioning.
The authors also reported that many patients did not adhere to the entire CBT program, even though it was brief. They suggested further study to explore why patients don't attend these groups. Despite the problems with attendance, adding cognitive therapy such ass CBT to the usual medication treatment appears to be the most effective way to treat panic disorder.
Reference: Arch Gen Psychiatry. 2005; 62:290-298. Available Online at http://www.archgenpsychiatry.com.
Last updated 11/4/05
