A meta-analysis of treatments for panic disorder with agoraphobia: imipramine, alprazolam, and in vivo exposure.
The most common pharmacological treatments for panic disorder with agoraphobia (PDA) include the use of imipramine and alprazolam while the most common behavior therapy is the use of graded in vivo exposure. Several studies have found these treatments to be superior to placebo in the treatment of PDA, but it has not been clear if there are differences among these three treatments. It has also not been clear for what aspects of PDA each treatment is the most effective. The purpose of this study was to conduct a meta-analysis of the results of relevant treatment outcome studies on a number of dependent variables (e.g., panic attack severity, dysphoria, avoidance behavior). Few studies satisfied the minimum criteria for inclusion and the final data pool consisted of 34 treatment studies. Imipramine was found to be generally ineffective for most variables. Alprazolam was significantly effective for panic and anxiety variables in PDA, while exposure was significantly effective for phobia variables. Exposure had the most consistently strong effect sizes.
Cox
B J
BJ
Anxiety Disorders Clinic, Clarke Institute of Psychiatry, Toronto, Ontario, Canada.
Endler
N S
NS
Lee
P S
PS
Swinson
R P
RP
D000379:Agoraphobia / Q000150:complications / Q000188:drug therapy*; D000525:Alprazolam / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use*; D008297:Male; D016584:Panic Disorder / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
D007099:Imipramine; D000525:Alprazolam