The Mutually Potentiating Effects of Imipramine and Exposure in Agoraphobia

Abstract

This paper will focus on six controlled studies which have investigated the relative and combined effects of behavioral and pharmacological treatments of agoraphobia (Zitrin et al. 1980, 1983; Marks et al. 1983; Mavissakalian et al. 1983; Telch et al. 1985; Mavissakalian and Michelson 1986a). The pharmacological agent in all of these studies is the tricyclic drug imipramine and, therefore, conclusions drawn from this review are more likely to generalize to some (e.g., phenelzine, chlorimipramine, zimeledine, desimipramine, and trazodone) but not all (e.g., benzodiazepines, in particular, aprazolam) pharmacological agents which have been reported to be effective in the treatment of panic disorder/agoraphobia. The behavioral treatment in the six studies includes instructions and encouragement for self-directed exposure to phobic situations with or without therapist-assisted in vivo exposure sessions.