Alprazolam and Exposure Alone and Combined in Panic Disorder with Agoraphobia
| Autor: | Isaac M. Marks, Richard P. Swinson, Metin Başoǧlu, Klaus Kuch, Homa Noshirvani, Geraldine O'Sullivan, Paul T. Lelliott, Marlene Kirby, Gary McNamee, Seda Sengun, Kim Wickwire |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Panic Disorder with Agoraphobia medicine.medical_treatment Exposure therapy Placebo 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Psychiatry Agoraphobia Aged Alprazolam Panic disorder Panic Middle Aged medicine.disease Combined Modality Therapy 030227 psychiatry Psychiatry and Mental health Phobic Disorders Anesthesia Female Desensitization Psychologic medicine.symptom Arousal Psychology Anxiety disorder Follow-Up Studies medicine.drug |
| Zdroj: | British Journal of Psychiatry. 162:776-787 |
| ISSN: | 1472-1465 0007-1250 |
| Popis: | A cross-national randomised trial of alprazolam for chronic panic disorder with agoraphobia was run. Compared with previous trials it had three new features: an exposure therapy contrast group, a six-month treatment-free follow-up, and a low rate of early placebo drop-outs (‘non-evaluables’). The dose of alprazolam was high (5 mg/day). The 154 patients had eight weeks of: alprazolam and exposure (combined treatment); or alprazolam and relaxation (a psychological placebo); or placebo and exposure; or placebo and relaxation (double placebo). Drug taper was from weeks 8 to 16. Follow-up was to week 43. Results were similar at both sites. Treatment integrity was good. All four treatment groups, including double placebo, improved well on panic throughout. On non-panic measures, by the end of treatment, both alprazolam and exposure were effective, but exposure had twice the effect size of alprazolam. During taper and follow-up, gains after alprazolam were lost, while gains after exposure were maintained. Combining alprazolam with exposure marginally enhanced gains during treatment, but impaired improvement thereafter. The new features put previous trials in a fresh light. By the end of treatment, though gains on alprazolam were largely as in previous studies, on phobias and disability they were half those with exposure. Relapse was usual after alprazolam was stopped, whereas gains persisted to six-month follow-up after exposure ceased. Panic improved as much with placebo as with alprazolam or exposure. |
| Databáze: | OpenAIRE |
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