Psycheducation.org (home) Panic Attack Treatment
Research Study Contrasts Medications and Psychotherapy
The best research study about how people with panic are doing, after treatment, was just published in a leading medical journal. The research approach was "as good as it gets": patients receiving medications were treated by a group well known for their success with those medications. Patients receiving the therapy approach were also treated by a team expert in that approach. If you ask "what works better, medications or therapy?", this is the study to look at -- it demonstrates the same results of smaller studies that were done previously, and adds to them the strongest research design yet. You can read the details in the Journal of the American Medical Association (2000 May 17;283(19):2529-36), or the abstract , or my brief summary below.
Imipramine, or Their Combination for Panic Disorder:
A Randomized Controlled Trial
David H. Barlow, PhD; Jack M. Gorman, MD; M. Katherine Shear, MD; Scott W. Woods, MD
As the title indicates, this is a randomized clinical trial (read about that research design here). Five different approaches were compared, which required 8 years of research in several centers:
Simplifying things a bit, here are the results, indicating the percentage of people "panic free" (no panic attacks at all):
|At end of initial treatment
|After 6 months of maintenance treatment||40%||38%||13%|
|Six months after treatment stopped||32%||20%||13%|
Combining imipramine with CBT was not clearly superior to CBT alone (it's a little complex how that came out, but the bottom line is pretty clear, at least in my view -- the medication does not add to the outcome, especially after the medication is tapered off).
"Bottom Line": Although there is a strong tendency for people to "relapse" into having panic attacks again after treatment is over, fewer people relapse if they received CBT than if they received an antidepressant.