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Psychotherapy plus anti-depressant for panic disorder with
or without agoraphobia: systematic review. British
Journal of Psychiatry 2006; Volume 188; pages
305-312.
Furukawa, T. A.,
Watanabe, N., and Churchill, R.
Psychotherapy, medication, or both can be used to treat
agoraphobia. The advantage of using both has been a topic of
debate. This recent meta-analysis (combining the results of 21
randomized and controlled studies) suggests that:
1) The combination of psychotherapy and use of
anti-depressants is more effective than using just one of
these treatments as long as treatment continues.
2) After treatment stops, the combination of both
psychotherapy and anti-depressants is more effective than
the use of anti-depressants alone at follow-up, however, not
more effective than psychotherapy alone.
In other words, if you are undergoing psychotherapy for
agoraphobia, taking an anti-depressant will increase
your likelihood of recovery and symptom relief.
But....once your treatment is over, only the psychotherapy
has lasting effects. The quality of psychotherapy is what
will help you stay well. Anti-depressants only help your
recovery while you are taking them and do not have any
lasting effects after you finish taking them.
The moral of the story is, make psychotherapy your primary
treatment for agoraphobia and add an anti-depressant if you think it might
help you during recovery. Also, remember that
anti-depressants are prescribed to people with agoraphobia
because they help prevent panic attacks. They are not as
likely to be
effective in treating general or free-floating anxiety as
benzodiazepines.
Never rely entirely on an
anti-depressant, or any other medication for recovery from
agoraphobia.
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