A comparison of medication side effect reports by panic disorder patients with and without concomitant cognitive behavior therapy.
OBJECTIVE
The authors assessed whether adding cognitive behavior therapy (CBT) to imipramine for patients with panic disorder decreased the severity of side effects and dropouts from side effects.


METHODS
Data were analyzed for 172 panic disorder patients who were randomly assigned to receive imipramine alone, imipramine plus CBT, or placebo. Mixed-effects models were used to assess longitudinal differences among the treatment groups with respect to side effect burden and dropout rates during the acute, maintenance, and follow-up phases of treatment.


RESULTS
Patients treated with imipramine plus CBT experienced less severe fatigue/weakness, dry mouth, and sweating and had a lower rate of dropout due to side effects compared with those treated with imipramine only.


CONCLUSIONS
The addition of CBT to medication treatment with imipramine was associated with less severe side effects and fewer dropouts due to perceived side effects than treatment with imipramine alone.
Marcus
Sue M
SM
Mount Sinai School of Medicine, Department of Psychiatry, Division of Biostatistics, Box 1230, One Gustave L. Levy Place, New York, NY 10029-6574. sue.marcus@mssm.edu.
Gorman
Jack
J
Shear
M Katherine
MK
Lewin
David
D
Martinez
Jose
J
Ray
Susan
S
Goetz
Raymond
R
Mosovich
Serge
S
Gorman
Lauren
L
Barlow
David
D
Woods
Scott
S
D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects* / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005221:Fatigue / Q000139:chemically induced; D006801:Humans; D006945:Hyperhidrosis / Q000139:chemically induced; D007099:Imipramine / Q000009:adverse effects* / Q000627:therapeutic use*; D016584:Panic Disorder / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D010919:Placebos; D012720:Severity of Illness Index; D013546:Sweating / Q000187:drug effects; D014987:Xerostomia / Q000139:chemically induced
D000929:Antidepressive Agents, Tricyclic; D010919:Placebos; D007099:Imipramine