Moclobemide and cognitive behavioral therapy in the treatment of social phobia. A six-month controlled study and 24 months follow up.
The aim of the study was to assess the 6-months treatment efficacy and 24-month follow up of three different therapeutic programs (A. moclobemide and supportive guidance, B. group cognitive-behavioral therapy and pill placebo, and C. combination of moclobemide and group cognitive-behavioral therapy) in patients with a generalized form of social phobia. Eighty one patients (38 males and 43 females) were randomly assigned to three different therapeutic programs. Patients were regularly assessed on a monthly basis by an independent rater on the LSAS (Liebowitz Social Anxiety scale), CGI (Clinical Global Impression) for severity and change and BAI (Beck Anxiety Inventory). Altogether, sixty-six patients completed the six month treatment period and 15 patients dropped out. All therapeutic groups showed significant improvement. A combination of CBT and pharmacotherapy yielded the most rapid effect. Moclobemide was superior for the reduction of the subjective general anxiety (BAI) during the first 3 months of treatment, but its influence on avoidant behavior (LSAS avoidance subscale) was less pronounced. Conversely, CBT was the best choice for reduction of avoidant behavior while a reduction of subjective general anxiety appeared later than in moclobemide. After 6 months of treatment there were best results reached in groups treated with CBT and there was no advantage of the combined treatment. The relapse rate during the 24-month follow up was significantly lower in the group treated with CBT in comparison with the group A. formerly treated with moclobemide alone.
Prasko
Ján
J
Psychiatric Centre Prague, Ustavní 91, 181 03 Prague 8, Czech Republic. prasko@pcp.lf3.cuni.cz
Dockery
Colleen
C
Horácek
Jirí
J
Houbová
Petra
P
Kosová
Jirina
J
Klaschka
Jan
J
Pasková
Beata
B
Praskova
Hana
H
Seifertová
Dagmar
D
Záleský
Richard
R
Höschl
Cyril
C
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000188:drug therapy / Q000523:psychology; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020912:Moclobemide / Q000627:therapeutic use*; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use*; D010352:Patient Dropouts; D010698:Phobic Disorders / Q000188:drug therapy* / Q000523:psychology*; D010919:Placebos; D011581:Psychological Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome
D008996:Monoamine Oxidase Inhibitors; D010919:Placebos; D020912:Moclobemide