Randomised placebo-controlled trial of moclobemide, cognitive-behavioural therapy and their combination in panic disorder with agoraphobia.
BACKGROUND
In the treatment of panic disorder with agoraphobia, the efficacy of pharmacological, psychological and combined treatments has been established. Unanswered questions concern the relative efficacy of such treatments.


OBJECTIVE
To demonstrate that moclobemide and cognitive-behavioural therapy (CBT) are effective singly and more effective in combination.


METHODS
Fifty-five patients were randomly assigned to an eight-week treatment of: moclobemide plus CBT; moclobemide plus clinical management ('psychological placebo'); placebo plus CBT; or placebo plus clinical management.


RESULTS
Comparisons between treatments revealed strong effects for CBT. Moclobemide with clinical management was not superior to placebo. The combination of moclobemide with CBT did not yield significantly better short-term results than CBI with placebo. The CBT results remained stable during a six-month follow-up, although a substantial proportion of patients treated with placebo plus CBT needed additional treatment.


CONCLUSIONS
CBT was highly effective in the treatment of panic disorder with agoraphobia and reduced agoraphobia to levels that were comparable to those of non-clinical controls.
Loerch
B
B
Department of Psychiatry, University of Mainz, Germany.
Graf-Morgenstern
M
M
Hautzinger
M
M
Schlegel
S
S
Hain
C
C
Sandmann
J
J
Benkert
O
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D000379:Agoraphobia / Q000188:drug therapy / Q000628:therapy*; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001549:Benzamides / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020912:Moclobemide; D016584:Panic Disorder / Q000188:drug therapy / Q000628:therapy*; D010349:Patient Compliance; D016896:Treatment Outcome
D000928:Antidepressive Agents; D001549:Benzamides; D020912:Moclobemide