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Pharmacotherapy of panic disorder.

Pull CB, Damsa C - Neuropsychiatr Dis Treat (2008)

Bottom Line: Treatment results obtained with CBT compare well with pharmacotherapy, with evidence that CBT is at least as effective as pharmacotherapy.Combining pharmacotherapy with CBT has been found to be superior to antidepressant pharmacotherapy or CBT alone, but only in the acute-phase treatment.Long term studies on treatments combining pharmacotherapy and CBT for PD with or without agoraphobia have found little benefit, however, for combination therapies versus monotherapies.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosciences, Centre Hospitalier de Luxembourg, rue Barblé, 1210 GD de Luxembourg. pull.charles@chl.lu

ABSTRACT
Panic disorder (PD) is a common, persistent and disabling mental disorder. It is often associated with agoraphobia. The present article reviews the current status of pharmacotherapy for PD with or without agoraphobia as well as the current status of treatments combing pharmacotherapy with cognitive behavior therapy (CBT). The review has been written with a focus on randomized controlled trials, meta-analyses, and reviews that have been published over the past few years. Effective pharmacological treatments include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and various benzodiazepines. Treatment results obtained with CBT compare well with pharmacotherapy, with evidence that CBT is at least as effective as pharmacotherapy. Combining pharmacotherapy with CBT has been found to be superior to antidepressant pharmacotherapy or CBT alone, but only in the acute-phase treatment. Long term studies on treatments combining pharmacotherapy and CBT for PD with or without agoraphobia have found little benefit, however, for combination therapies versus monotherapies. New investigations explore the potential additional value of sequential versus concomitant treatments, of cognitive enhancers and virtual reality exposure therapy, and of education, self management and Internet-based interventions.

No MeSH data available.


Related in: MedlinePlus

Virtual reality environments are presented using a head mounted display and tracking head movement.
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fig1: Virtual reality environments are presented using a head mounted display and tracking head movement.

Mentions: Another ongoing randomized controlled investigation involving the Collège de France and 3 university hospitals (in Luxembourg, Lyon, and Paris) compares the efficacy of traditional CBT, VRET, and a waiting list in patients meeting DSM-IV criteria for PD with agoraphobia (Pull et al 2006). CBT and VRET are given in 12 sessions of 90 minutes’ duration. Both types of treatment are provided by the same clinicians who are experienced therapists. CBT includes respiratory control, cognitive restructuring, exposure in imagination to anxiety provoking scenes and interoceptive exposure to anxiety-related physical sensations, and homework involving exposure to real-life situations. VR environments are presented using a head mounted display and tracking head movement (Kaiser Electro-Optics Proview 60™, Germany) (Figure 1). VRET includes exposure to 12 virtual environments (taking a subway, walking in a tunnel, taking an elevator, shopping in a supermarket, driving a car on a lonely country road, traveling by plane, entering a movie theatre, driving a car in a city, driving a car in a tunnel, traveling by bus, walking in a crowd, being caught in a sensorial conflict) provoking a feeling of derealization. Initial results of the study indicate that there are no significant differences in outcome measures between patients treated by VRET and patients treated by traditional CBT.


Pharmacotherapy of panic disorder.

Pull CB, Damsa C - Neuropsychiatr Dis Treat (2008)

Virtual reality environments are presented using a head mounted display and tracking head movement.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2536545&req=5

fig1: Virtual reality environments are presented using a head mounted display and tracking head movement.
Mentions: Another ongoing randomized controlled investigation involving the Collège de France and 3 university hospitals (in Luxembourg, Lyon, and Paris) compares the efficacy of traditional CBT, VRET, and a waiting list in patients meeting DSM-IV criteria for PD with agoraphobia (Pull et al 2006). CBT and VRET are given in 12 sessions of 90 minutes’ duration. Both types of treatment are provided by the same clinicians who are experienced therapists. CBT includes respiratory control, cognitive restructuring, exposure in imagination to anxiety provoking scenes and interoceptive exposure to anxiety-related physical sensations, and homework involving exposure to real-life situations. VR environments are presented using a head mounted display and tracking head movement (Kaiser Electro-Optics Proview 60™, Germany) (Figure 1). VRET includes exposure to 12 virtual environments (taking a subway, walking in a tunnel, taking an elevator, shopping in a supermarket, driving a car on a lonely country road, traveling by plane, entering a movie theatre, driving a car in a city, driving a car in a tunnel, traveling by bus, walking in a crowd, being caught in a sensorial conflict) provoking a feeling of derealization. Initial results of the study indicate that there are no significant differences in outcome measures between patients treated by VRET and patients treated by traditional CBT.

Bottom Line: Treatment results obtained with CBT compare well with pharmacotherapy, with evidence that CBT is at least as effective as pharmacotherapy.Combining pharmacotherapy with CBT has been found to be superior to antidepressant pharmacotherapy or CBT alone, but only in the acute-phase treatment.Long term studies on treatments combining pharmacotherapy and CBT for PD with or without agoraphobia have found little benefit, however, for combination therapies versus monotherapies.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosciences, Centre Hospitalier de Luxembourg, rue Barblé, 1210 GD de Luxembourg. pull.charles@chl.lu

ABSTRACT
Panic disorder (PD) is a common, persistent and disabling mental disorder. It is often associated with agoraphobia. The present article reviews the current status of pharmacotherapy for PD with or without agoraphobia as well as the current status of treatments combing pharmacotherapy with cognitive behavior therapy (CBT). The review has been written with a focus on randomized controlled trials, meta-analyses, and reviews that have been published over the past few years. Effective pharmacological treatments include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and various benzodiazepines. Treatment results obtained with CBT compare well with pharmacotherapy, with evidence that CBT is at least as effective as pharmacotherapy. Combining pharmacotherapy with CBT has been found to be superior to antidepressant pharmacotherapy or CBT alone, but only in the acute-phase treatment. Long term studies on treatments combining pharmacotherapy and CBT for PD with or without agoraphobia have found little benefit, however, for combination therapies versus monotherapies. New investigations explore the potential additional value of sequential versus concomitant treatments, of cognitive enhancers and virtual reality exposure therapy, and of education, self management and Internet-based interventions.

No MeSH data available.


Related in: MedlinePlus