A randomized controlled study of paroxetine and cognitive-behavioural therapy for late-life panic disorder.
OBJECTIVE
To examine the effectiveness of paroxetine and cognitive-behavioural therapy (CBT) in elderly patients suffering from panic disorder with or without agoraphobia (PD(A)).


METHODS
Forty-nine patients aged 60+ years with confirmed PD(A) were randomly assigned to 40 mg paroxetine, individual CBT, or to a 14-week waiting list. Outcomes, with avoidance behaviour and agoraphobic cognitions being the primary measures, were assessed at baseline and at weeks 8, 14 (conclusion CBT/waiting list), and at week 26 (treated patients only) and analysed using mixed models.


RESULTS
All outcome measures showed that the patients having received CBT and those treated with paroxetine had significantly better improvement compared with those in the waiting-list condition. With one patient (1/20, 5%) in the CBT and three (3/14, 17.6%) in the paroxetine condition dropping out, attrition rates were low.


CONCLUSIONS
Patients with late-life panic disorder respond well to both paroxetine and CBT. Although promising, the outcomes warrant replication in larger study groups.
Hendriks
G-J
GJ
Forum GGz Nijmegen, Department for Anxiety Disorders "Overwaal", Nijmegen, the Netherlands. ghendriks@overwaal.nl <ghendriks@overwaal.nl>
Keijsers
G P J
GP
Kampman
M
M
Oude Voshaar
R C
RC
Verbraak
M J P M
MJ
Broekman
T G
TG
Hoogduin
C A L
CA
D000368:Aged; D000379:Agoraphobia / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016584:Panic Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D017374:Paroxetine / Q000008:administration & dosage*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors