A COMPARISON OF COGNITIVE THERAPY, APPLIED RELAXATION AND IMIPRAMINE IN THE TREATMENT OF PANIC DISORDER

Recent studies have shown that cognitive therapy is an effective treat ment for panic disorder. However, little is known about how cognitive therapy compares with other psychological and pharmacological treatmen ts. To investigate this question 64 panic disorder patients were initi ally assigned to cognitive therapy, applied relaxation, imipramine (me an 233 mg/day), or a 3-month wait followed by allocation to treatment. During treatment patients had up to 12 sessions in the first 3 months and up to three booster sessions in the next 3 months. Imipramine was gradually withdrawn after 6 months. Each treatment included self-expo sure homework assignments. Cognitive therapy and applied relaxation se ssions lasted one hour. Imipramine sessions lasted 25 minutes. Assessm ents were before treatment/wait and at 3, 6, and 15 months. Comparison s with waiting-list showed all three treatments were effective. Compar isons between treatments showed that at 3 months cognitive therapy was superior to both applied relaxation and imipramine on most measures. At 6 months cognitive therapy did not differ from imipramine and both were superior to applied relaxation on several measures. Between 6 and 15 months a number of imipramine patients relapsed. At 15 months cogn itive therapy was again superior to both applied relaxation and imipra mine but on fewer measures than at 3 months. Cognitive measures taken at the end of treatment were significant predictors of outcome at foll ow-up.