Psychotherapy plus antidepressant for panic disorder with or without agoraphobia: systematic review.
BACKGROUND
Panic disorder can be treated with psychotherapy, pharmacotherapy or a combination of both.


OBJECTIVE
To summarise the evidence concerning the short- and long-term benefits and adverse effects of a combination of psychotherapy and antidepressant treatment.


METHODS
Meta-analyses and meta-regressions were undertaken using data from all relevant randomised controlled trials identified by a comprehensive literature search. The primary outcome was relative risk (RR) of response.


RESULTS
We identified 23 randomised comparisons (21 trials involving a total of 1709 patients). In the acute-phase treatment, the combined therapy was superior to antidepressant pharmacotherapy (RR=1.24,95% CI1.02-1.52) or psychotherapy (RR=1.16,95% CI1.03-1.30). After termination of the acute-phase treatment, the combined therapy was more effective than pharmacotherapy alone (RR=1.61,95% CI1.23-2.11) and was as effective as psychotherapy (RR=0.96, 95% CI 0.79-1.16).


CONCLUSIONS
Either combined therapy or psychotherapy alone may be chosen as first-line treatment for panic disorder with or without agoraphobia, depending on the patient's preferences.
Department of Psychiatry and Cognitive-Behavioural Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City University Medical School, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. furukawa@med.nagoya-cu.ac.jp
Toshi A
TA
Furukawa
Norio
N
Watanabe
Rachel
R
Churchill
D000328:Adult; D000379:Agoraphobia / Q000523:psychology*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001521:Behavior Therapy; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000523:psychology / Q000628:therapy*; D011613:Psychotherapy; D016896:Treatment Outcome
D000928:Antidepressive Agents