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Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia

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van Apeldoorn FJ, van Hout WJPJ, Mersch PPA, Huisman M, Slaap BR, Hale WW III, Visser S, van Dyck R, den Boer JA. 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. Method: 

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. Conclusion: 

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.
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Keywords: agoraphobia; cognitive-behavioral therapy; drug treatment; panic disorder; randomized controlled trials

Document Type: Research Article

Affiliations: 1: University Medical Center Groningen 2: University of Groningen 3: Global Clinical Development, N.V. Organon, Oss 4: Utrecht University, Research Center Adolescent Development 5: VU University Medical Center, Amsterdam, the Netherlands

Publication date: 2008-04-01

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