Panic disorder cognitive therapy

As with panic disorder, cognitive-behavioral therapy is an important part of the treatment program for social anxiety disorder. Some evidence suggests that in some cases, drug treatment did not improve the effects of receiving cognitive-behavior therapy. 

In two studies in which benzodia2epines were gradually tapered, concurrent cognitive-behavioral therapy (CBT) did not increase the proportion of patients who were able to successfully discontinue their use of these agents (Oude Voshaar et al. 2003 Vorma et al. 2003). On the other hand, other studies of patients with panic disorder found that CBT facilitated the discontinuation of benzodiazepine use (Otto et al. 1993). Similarly, CBT may be superior to supportive medical management in preventing the reoccurrence of panic attacks in panic disorder patients in whom alprazolam has been tapered (Bruce etal. 1999). 

Bruce TJ, Spiegel DA, Hegel MT Cognitive-behavioral therapy helps prevent relapse and recurrence of panic disorder following alprazolam discontinuation a longterm follow-up of the Peoria and Dartmouth studies. J Consult Clin Psychol 67 151-156, 1999... 

Otto MW, Pollack MH, Sachs GS, et al Discontinuation of benzodiazepine treatment efficacy of cognitive-behavioral therapy for patients with panic disorder. Am J... 

The hrst-line treatments for panic disorder are (1) cognitive-behavioral therapy (CBT), (2) benzodiazepines, and (3) SSRIs/SNRls. Each of these three treatment modalities can be nsed independently or in combination. The selection of the primary treatment depends on several factors inclnding severity and frequency of the panic attacks, comorbid illnesses, and patient preference. 

Shear MK, Pyer AJ, Josephson S, Pitzpatrick M, Klein DP (1991) Vulnerability to soditun lactate in panic disorder patients given cognitive therapy. Am J Psychiatry 148 795-797... 

Barlow DH, Gorman JM, Shear MK, Woods SW (2000) Cognitive-behavioral therapy, imipramine, or their combination for panic disorder a randomized controlled trial. JAMA 283 2529-2536... 

Loerch, B., Graf-Morgenstern, M., Hautzinger, M., Schlegel, S., Hain, C., Sandmann, J., and Benkert, O. (1999) Randomised placebo-controlled trial of moclobemide, cognitive-behavioural therapy and their combination in panic disorder with agoraphobia. Br J Psychiatry 174 205-212. 

Note. BROF = brofaromine CIT = citalopram CLO = clomipramine CT = cognitive therapy Dx = diagnosis EXP = exposure in vivo FLU = fluvoxamine FLUOX = fluoxetine GAD = generalized anxiety disorder 5-HTP = 5-hydrox3rtryptophan IMl = imipramine MAP = maprotiline OCD = obsessive-compulsive disorder PAR = paroxetine PD = panic disorder PLA = placebo PPM = psychological panic management RIT = ritanserin ... 

Black DW, Wesner R, Bowers W, et al A comparison of fluvoxamine, cognitive therapy and placebo in the treatment of panic disorder. Arch Gen Psychiatry 50 44-50, 1993... 

Welko vit2. L.A.. Papp, L.A., Cloitre. M., et aL . Cognitive-behavior therapy for panic disorder delivered by psychopharmacologically oriented clinicians J. Nerv. AJent. Dis. 179, 473-477, 1991. 

This syndrome often develops in patients in their twenties, and some, with the more severe form, rarely leave home for periods of many years, or until they are effectively treated by medication, cognitive behavior therapy, or other behavior/psychological therapies. Family studies of panic disorder (PD) find an increased occurrence of attacks in first-degree relatives (2). 

Klosko JS, Barlow DH, Tassinari RB, et al. Alprazolam vs. cognitive behavior therapy for panic disorder a preliminary report. In Hand I, Witchen HU, eds. Panic and phobias. New York Springer Verlag, 1988 54-65. 

Martinsen EW, Olsen T, Tonset E, et al. Cognitive-behavioral group therapy for panic disorder in the general clinical setting a naturalistic study with 1-year follow-up. J Clin Psychiatry 1998 59 437-442. 

Spiegel DA, Bruce TJ. Benzodiazepines and exposure-based cognitive behavior therapies for panic disorder conclusions from combined treatment trials. Am J Psychiatry 1997 154 773-781. 

Otto MW, Pollack MH, Penava SJ, et al. Group cognitive-behavior therapy for patients failing to respond to pharmacotherapy for panic disorder a clinical case series. Behav Res Ther 1999 37 763-770. 

Bakker A, van Dyck R, Spinhoven P, et al. Paroxetine, clomipramine, and cognitive therapy in the treatment of panic disorder. J Clin Psychiatry 1999 60 831-838. 

To review the drug treatments of panic disorder, including benzodiazepines, serotonin selective reuptake inhibitors, cognitive behavioral therapy and other treatments. 

Behavioral therapies and cognitive therapies are commonly less effective for the treatment of panic disorder and obsessive compulsive disorder than are the SSRIs. 

Although anxiety disorders, when untreated, can be the cause of substantial personal suffering, disability, and marital and family disruption, the progress made in the therapeutic area for conditions like panic disorder, OCD, and GAD, among other anxiety disorders, makes these conditions very gratifying to treat. Indeed, the skillful use of psychotherapies—cognitive-behavioral therapies appear to be most effective—and medications can produce dramatic and lasting improvement in many patients. 

Beck, J. G., Stanley, M. A., Baldwin. L. E., Deagle, E. A. (1994). Comparison of cognitive therapy and relaxation training for panic disorder. Journal of Consulting Clinical Psychology, 64, 818-826. 

Clark. D. B., Salkovskis, P. M., Hackmann, A., Middleton, H., Anastasiades, P., Gelder, M. (1994). A comparison of cognitive therapy, applied relaxation and imipramine in the treatment of panic disorder. British Journal of Psychiatry, 164, 759-769. 

Ost, L. A., Westling, B. E. (1995). Applied relaxation vs. cognitive behavior therapy in the treatment of panic disorder. Behavior Research and Therapy, 33, 145-158. 

Pharmacotherapy is only one of several treatment options for PTSD, especially in view of the great success of cognitive-behavioral therapy (CBT). Medication may be a good choice when patient acceptability of such an approach is high, when comorbid conditions are present that are responsive to pharmacotherapy (e.g. depression, panic disorder, social phobia, and obsessive-compulsive disorder), or when CBT is not applicable. ... 

Standardized cognitive behavioral therapy manuals, which ensure adherence to a treatment protocol, have been developed for many different anxiety disorders, including phobias, generalized anxiety, panic, social anxiety, Agoraphobia,... 

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