To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: DG DISPATCH - ECNP: Triple Therapy Best For Panic Disorder With Agoraphobia URL: http://www.pslgroup.com/dg/131E8E.htm Doctor's Guide September 24, 1999
By Olwen Glynn Owen Special to DG News
LONDON, UK -- September 24, 1999 -- People suffering from panic disorder with agoraphobia (PDA) respond best to a triple therapy combination including cognitive-behavior therapy (CBT), high-potency benzodiazepine and the serotonin reuptake inhibitor fluoxetine (FLX), new research shows.
These findings, from a Yugoslavian-US study, were presented by Dr. Vladan Starcevic, from the Belgrade Institute of Mental Health, Belgrade, Yougoslavia, at the 12th congress of the European College of Neuropsychopharmacology, being held this week in London, UK.
In the unrandomised, open label, 10-week study, researchers compared three treatment approaches in 88 patients with a DSM-IV diagnosis of PDA. Patients received, either CBT alone, CBT plus a benzodiazepine or CBT plus benzodiazepine + fluoxetine.
Severity of the patients' condition was scored at baseline and study end using the Panic Disorder Severity Scale (PDSS) and the Panic and Agoraphobia Scale (P&A). Patients with more severe disease at baseline tended to be allocated the triple therapy.
Choice of benzodiazepine agents selected were alprazolam 1-4 milligrams/day or clonazepam 0.5-4 milligrams/day with mean doses of 1.86 mg/day or 1.30 mg/day respectively. The dose range for fluoxetine was 20-30mg/day with a mean dose of 20.48 mg/day administered. Dosages were titrated up over the initial two weeks of treatment. CBT was administered via twice-weekly office sessions.
The scores for the three groups, evaluating change from baseline to study end over the 10 weeks revealed the triple combination was significantly superior (p<0.01) to either the dual therapy or CBT alone. The authors commented that adding a benzodiazepine to CBT added little or no benefit to outcome whereas the further addition of an SRI produced a substantial reduction in symptom severity. "The addition of fluoxetine to CBT may be beneficial, particularly because of the effect of fluoxetine on agoraphobia," Dr. Starcevic.
This study did not investigate the dual therapy combination of CBT + FLX. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.