Advertisement

Comparison of Alprazolam and Cognitive Behavior Therapy in the Treatment of Panic Disorder: A Preliminary Report

Conference paper

Abstract

Pharmacological treatments are well established for panic disorder. Clinical evidence exists for the effectiveness of tricyclic antidepressants, monoamine oxidase inhibitors, and benzodiazepines (Barlow, in press). However, many of these reports are uncontrolled, open clinical trials conducted with heterogeneous groups of patients. More rigorous controlled trials seem to demonstrate that tricyclic antidepresants, in particular imipramine, can confer a significant advantage on psychologically based exposure therapies. Studies by Zitrin et al. (1980, 1983) have examined the separate and combined effects of imipramine and group in vivo exposure (Zitrin et al. 1980) or imaginal exposure (Zitrin et al. 1983). Generally, behavioral treatments produced improvement, but imipramine conferred an advantage on these behavioral treatments. Similar results have been reported by Telch et al. (1985) and Mavissakalian and Michelson (1986). Only Marks et al. (1983) have reported that no particular advantage was conferred by adding imipramine to exposure-based treatments.

Keywords

Generalize Anxiety Disorder Panic Disorder Panic Attack Panic Symptom Uncontrolled Clinical Trial 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Alexander P, Alexander D (1986) Alprazolam treatment for panic disorders. J Clin Psychiatry 48: 301–304Google Scholar
  2. Ballenger JC, Burrows G, DuPont R, Lesser I, Noyes R, Pecknold J, Riskin A, Swinson R (in press) Alprazolam in panic disorder and agoraphobia; results from a multi center trial. I. Efficacy in short-term treatment. Arch Gen PsychiatryGoogle Scholar
  3. Barlow DH (in press) Anxiety and its disorders. Guilford, New YorkGoogle Scholar
  4. Barlow DH, Beck JG (1984) The psychosocial treatment of anxiety disorders. current status, future directions. In: Williams JBW, Spitzer RL (eds) Psychotherapy research: where are we and where should we go? Guilford, New YorkGoogle Scholar
  5. Barlow DH, Cerny JA (in press) Psychological treatment of panic. Guilford, New YorkGoogle Scholar
  6. Barlow DH, Cohen AS, Waddell MT, Vermilyea BB, Klosko JS, Blanchard EB, DiNardo PA (1984) Panic and generalized anxiety disorders: nature and treatment. Behav Res Ther 15: 431–449CrossRefGoogle Scholar
  7. Beck AT (in press) Cognitive approaches to panic disorder: theory and therapy. In: Rachman S, Maser JD (eds) Panic: psychological perspectives. Erlbaum, HillsdaleGoogle Scholar
  8. Beck AT, Emery G (1979) Cognitive therapy of anxiety and phobic disorders. Center for Cognitive Therapy, PhiladelphiaGoogle Scholar
  9. Beck AT, Emery G (1985) Anxiety and the anxiety disorders. Erlbaum, HillsdaleGoogle Scholar
  10. Bernstein DA, Borkovec TD (1973) Progressive relaxation training. Ill: Research Press, ChampaignGoogle Scholar
  11. Chouinard G, Annable L, Fontaine R, Solyom L (1982) Alprazolam in the treatment of generalized anxiety and panic disorders: a double-blind placebo-controlled study. Psychopharmacology 77: 229–233PubMedCrossRefGoogle Scholar
  12. Clark DM, Salkovskis PM, Chalkley AJ (1985) Respiratory control as a treatment for panic attacks. J Beh Ther Exp Psychiatry 16: 23–30CrossRefGoogle Scholar
  13. Craske MG, Barlow DH (1987) Behavioral treatment of panic: a controlled study. 21st Annual convention of the Association for the Advancement of Behavior Therapy. Boston, November 1987Google Scholar
  14. DiNardo PA, O’Brien GT, Barlow DH, Waddell MT, Blanchard EB (1983) Reliability of DSMIII anxiety disorder categories using a new structured interview. Arch Gen Psychiatry 40: 1070–1078PubMedGoogle Scholar
  15. DiNardo PA, Barlow DH, Cerny J, Vermilyea JA, Vermilyea BB, Himadi W, Waddell M (1985) The anxiety disorders interview schedule - revised. Center for Stress and Anxiety Disorders, New YorkGoogle Scholar
  16. Fontaine R, Chouinard G, Annable L (1984) Rebound anxiety in anxious patients after abrupt withdrawal of benzodiazepine treatment. Am J Psychol 141: 848–852Google Scholar
  17. Fyer A, Liebowitz M, Gorman J, Compeas R, Levin A, Davies S, Goetz D, Klein D (1987) Discontinuation of alprazolam treatment in panic patients. Am J Psychiatry 144: 303–308PubMedGoogle Scholar
  18. Gitlin B, Martin M, Shear K, Frances A, Ball G, Josephson S (1985) Behavior therapy for panic disorder. J Nery Men Dis 173: 742–743CrossRefGoogle Scholar
  19. Klosko JS, Barlow DH (1987) The treatment of panic in panic disorder and agoraphobia: a clinical replication series. Behav Res Ther Unpublished manuscriptGoogle Scholar
  20. Liebowitz MR, Fyer A, Gorman J, Campas R, Levin A, Davies S, Goeth D, Klein D (1986) Alprazolam in the treatment of panic disorders. J Clin Psychopharamcol 6: 13–20CrossRefGoogle Scholar
  21. Marks IM, Grey S, Cohen SD, Hill R, Mawson D, Ramm L, Stern RS (1983) Imipramine and brief therapist-aided exposure in agoraphobies having self-exposure homework: a controlled trial. Arch Gen Psychiatry 40: 153–162PubMedGoogle Scholar
  22. Mavissakalian M, Michelson L (1986) Agoraphobia: relative and combined effectiveness of therapist-assisted in vivo exposure and imipramine. J Clin Psychiatry 47: 117–122PubMedGoogle Scholar
  23. Noyes R, Anderson DJ, Clancy J, Crowe RR, Slymen DJ, Ghoneim MM, Hinrichs JV (1984) Diazepam and propranolol in panic disorder and agoraphobia. Arch Gen Psychiatry 41: 287–292PubMedGoogle Scholar
  24. Salkovskis PM, Jones DRO, Clark DM (1986) Respiratory control in the treatment of panic attacks: replication and extension with concurrent measurement of behavior and pCO2. Br J Psychiatry 148: 526–532PubMedCrossRefGoogle Scholar
  25. Teich MJ, Agras WS, Taylor CB, Roth WT, Gallen C (1985) Combined pharmacological and behavioural treatment for agoraphobia. Behav Res Ther 23: 325–335CrossRefGoogle Scholar
  26. Zitrin CM, Klein DF, Woerner MG (1980) Treatment of agoraphobia with group exposure in vivo and imipramine. Arch Gen Psychiatry 37: 63–72PubMedGoogle Scholar
  27. Zitrin CM, Klein DF, Woerner MG, Ross DC (1983) Treatment of phobias: I. Comparison of imipramine hydrochloride and placebo. Arch Gen Psychiatry 40: 125–138PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

There are no affiliations available

Personalised recommendations