Panic Management, Trazodone and a Combination of Both in the Treatment of Panic Disorder

Abstract

Background—The aim of the study was to assess the short‐term efficacy of panic management, trazodone and a combination of both in the treatment of panic disorder. In none of the treatments exposure in vivo instructions were given. Method—Patients were diagnosed using DSM‐III‐R criteria for panic disorder. A randomly assigned, comparative design was used in which patients were their own controls. Fifty‐two of 60 outpatients who entered the study, completed the 6‐week baseline and 6‐week active treatment period. Outcome measures included self‐report measures for panic frequency, panic intensity, agoraphobic anxiety and avoidance, and depression. Results—There was significant improvement on all symptom dimensions during treatment in contrast to the baseline period. No evidence for a differential efficacy of the three treatments was found. Both dropout and improvement rates were substantially lower than those reported in previous studies of behaviour therapy and antidepressants or a combination of both in panic patients. Conclusion—It is concluded that the short‐term effects of panic management and trazodone without concurrent exposure in vivo instructions are marginal and comparable to those of placebo as reported in previous studies. It is suggested to evaluate the efficacy of a prescriptive simple component therapy versus a multicomponent psychotherapy for panic.

The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta‐analysis of direct comparisons

“…A total of 67 studies met the inclusion criteria for this meta‐analysis. Selected characteristics of the included studies are reported in Table .…”

Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis

“…The flow chart describing the inclusion process, including the reasons for exclusion, is presented in Figure . A total of 52 studies met inclusion criteria for this meta‐analysis . Selected characteristics of the included studies are reported in Table .…”

Psychotherapy plus antidepressant for panic disorder with or without agoraphobia

“…With regard to validity, all but four comparisons from three trials (Mavissakalian & Michelson, 1986; Wiborg & Dahl, 1996; Berger et al , 2004) scored B for allocation concealment. In total, 19 studies conducted blinded outcome assessments and four studies were unblinded (Mavissakalian et al , 1983; Spinhoven et al , 1996; Azhar, 2000; Berger et al , 2004). The interrater reliability of these two validity criteria was 94% for allocation concealment and 83% for outcome assessment.…”