Clomipramine in the treatment of agoraphobic inpatients resistant to behavioral therapy.
BACKGROUND
Both behavior-modification methods and antidepressants have proved to be effective in the treatment of agoraphobia. The authors examined the effects of clomipramine on agoraphobia in patients who failed to respond to exposure-based behavioral treatment.


METHODS
Eighteen patients with panic disorder with agoraphobia who had not responded to previous inpatient behavioral treatment were recruited to a 12-week, placebo-controlled, double-blind crossover study of clomipramine, at top doses of 150 mg/day for 3 weeks. The patients were assessed on measures of phobic avoidance, agoraphobic cognitions, panic, state and trait anxiety, subjective anxiety, and depression.


RESULTS
One patient dropped out of the study after 6 weeks. On most outcome measures, the 17 study completers had significantly (p < .05) lower symptom scores at posttest in the active drug period than at posttest in the placebo period; however, the clinical gains were modest.


CONCLUSIONS
The short-term efficacy of clomipramine for agoraphobic patients who failed to respond lastingly to behavioral treatment was demonstrated. It remains to be shown that clomipramine can lead to clinically significant and lasting benefits in these patients.
Hoffart
A
A
Research Institute, Modum Bads Nervesanatorium, Vikersund, Norway.
Due-Madsen
J
J
Lande
B
B
Gude
T
T
Bille
H
H
Torgersen
S
S
D000328:Adult; D000379:Agoraphobia / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy; D002997:Clomipramine / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D010919:Placebos; D016896:Treatment Outcome
D010919:Placebos; D002997:Clomipramine