Drugs and psychological treatments for agoraphobia/panic and obsessive-compulsive disorders: a review.
In the short term, both antidepressants and exposure therapy usually improve agoraphobia/panic (AP) and obsessive-compulsive (OC) disorders and are accepted by most patients; psychological methods omitting exposure are not consistently helpful. Antidepressants have a broad-spectrum rather than specific anti-agoraphobia/panic or anti-obsessive-compulsive action. For long-term efficacy, there is good evidence for the value of exposure, but none for drugs. Because of relapse on ceasing drugs, and their side-effects, medication is less useful as the first line of treatment for chronic agoraphobia/panic or obsessive-compulsive disorder than is the lastingly helpful approach of exposure. Antidepressants are worth trying when patients refuse or fail with exposure therapy, or are dysphoric.
Marks
I
I
Institute of Psychiatry, London.
O'Sullivan
G
G
D000379:Agoraphobia / Q000628:therapy*; D000928:Antidepressive Agents / Q000627:therapeutic use; D005239:Fear; D006185:Habituation, Psychophysiologic; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D010200:Panic; D010698:Phobic Disorders / Q000628:therapy*; D011613:Psychotherapy; D013997:Time Factors
D000928:Antidepressive Agents; D007099:Imipramine