Researchers from the University Medical Center Groningen in The Netherlands investigated whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (Sustained Seratonin Reuptake Inhibitors, or SSRI’s, such as Prozac, Zoloft, Paxil, Luvox, Lexapro, etc) was more effective in treating panic disorder (PD) than either CBT or SSRI’s alone, and to evaluate any differential effects between the single treatments.

One hundred fifty patients with panic disorder randomly received either CBT only, SSRI’s only or CBT plus SSRI’s. Outcome was assessed after 9 months, before the medication was tapered off. The CBT plus SSRI protocol was clearly superior to CBT in both completer and intent-to-treat (ITT) analysis. Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT plus SSRI and SSRI. Both single treatments (CBT only and SSRI only) and the combined treatment (CBT plus SSRI) proved to be effective treatments for PD. At post-test, CBT + SSRI was clearly superior to CBT, but differences between CBT + SSRI and SSRI, and between SSRI and CBT, were small.

Citation: van Apeldoorn FJ, van Hout WJ, Mersch PP, Huisman M, Slaap BR, Hale WW 3rd, Visser S, van Dyck R, den Boer JA. Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia. Acta Psychiatr Scand. 2008 Apr; 117 (4): pages 260-70. Epub 2008 Feb 26. [email protected]