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Online Cognitive Behavior TX Plus Zoloft Helps Panic Disorder

29 May

Researchers from the University of Ottawa in Ontario, Canada investigated whether combining sertraline (Zoloft) and self-administered cognitive behavior therapy (SCBT) could improve treatment outcomes for panic disorder.
Two hundred fifty-one patients were randomized to 12 weeks of either a placebo drug, a placebo drug plus SCBT, sertraline alone or sertraline plus SCBT. Those who improved after 12 weeks of acute treatment then received treatment for an additional 12 weeks.

Outcome measures evaluate the core Panic Disorder symptoms (panic attacks, anticipatory anxiety, agoraphobic avoidance), dysfunctional ideas (fear of bodily sensations, agoraphobic ideas), disability, and clinical global impression of severity and improvement.

Primary analyses of trends over time revealed that the sertraline/SCBT combination produced a significantly greater rate of decline in fear of bodily sensations, as compared to sertraline alone, placebo with SCBT and placebo alone. Trends in other outcomes were not significantly different over time.

Secondary analyses of mean scores at week 12 revealed that the sertraline/SCBT combo fared better on several outcomes over placebo, with improvement being maintained at the end of the continuation treatment.  Outcome did not differ between placebo and either sertraline monotherapy or placebo/SCBT. Moreover, few differences emerged between the active interventions.

The researchers conclude that sertraline combined with SCBT may be an effective treatment for PD. The study could not confirm the efficacy of sertraline alone or SCBT without concomitant medication or therapist assistance in the treatment of Panic Disorder.

Citation:  Koszycki D, Taljaard M, Segal Z, Bradwejn J. A randomized trial of sertraline, self-administered cognitive behavior therapy, and their combination for panic disorder. Psychological Medicine. 2011 Feb; 41 (2): pages 373-83. Epub 2010 May 13. This email address is being protected from spambots. You need JavaScript enabled to view it.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award