Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia.
OBJECTIVE
To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono-treatments.


METHODS
Patients with PD (n = 150) with or without agoraphobia received CBT, SSRI or CBT + SSRI. Outcome was assessed after 9 months, before medication taper.


RESULTS
CBT + SSRI was clearly superior to CBT in both completer and intent-to-treat analysis (ITT). Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT + SSRI and SSRI.


CONCLUSIONS
Both the mono-treatments (CBT and SSRI) and the combined treatment (CBT + SSRI) proved to be effective treatments for PD. At post-test, CBT + SSRI was clearly superior to CBT, but differences between CBT + SSRI and SSRI, and between SSRI and CBT, were small.
van Apeldoorn
F J
FJ
University Medical Center Groningen, Groningen, The Netherlands. f.j.van.apeldoorn@psy.umcg.nl
van Hout
W J P J
WJ
Mersch
P P A
PP
Huisman
M
M
Slaap
B R
BR
Hale
W W
WW
Visser
S
S
van Dyck
R
R
den Boer
J A
JA
D000293:Adolescent; D000328:Adult; D000379:Agoraphobia / Q000188:drug therapy / Q000628:therapy*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D017367:Selective Serotonin Reuptake Inhibitors