DOES CONCURRENT DRUG INTAKE AFFECT THE LONG-TERM OUTCOME OF GROUP COGNITIVE-BEHAVIOR THERAPY IN PANIC DISORDER WITH OR WITHOUT AGORAPHOBIA

The present study investigated the impact of pre-existing pharmacother apy regimes on the long-term outcome of brief intensive group cognitiv e-behavioural therapy (BIGCBT) in the treatment of panic disorder with or without agoraphobia in 106 patients (74 females). Forty patients w ere allocated to BIGCBT without medication, 40 to BIGCBT plus anti-anx iety medication, IO to BIGCBT plus anti-depressant medication and 16 t o BIGCBT plus combined anti-anxiety and anti-depressant medications. T he mean follow-up period was 3.2 yr and ranged from 1.1 to 6.2 yr. The results demonstrated that patients who received BIGCBT concurrent wit h pre-existing medication regimes did not differ significantly (P > 0. 001) from each other or from patients who underwent BIGCBT without med ication on any of the dependent measures either at pre-treatment asses sment or long-term follow-up. However, BIGCBT (with or without pharmac otherapy) was associated with significant (P < 0.001) long-term improv ements in frequency of panic attacks, avoidance behaviour and question naire measures of anxiety, depression and agoraphobia. Furthermore, th e large majority (80%) of patients in the BIGCBT without medication gr oup remained medication-free at long-term follow-up. Of those patients who underwent BIGCBT concurrent with pre-existing pharmacotherapy, a large percentage (44%) reported no longer taking medication for their condition at long-term follow-up. Overall, it is concluded that pre-ex isting medication regimes (anti-anxiety, anti-depressant or combinatio ns of these) do not significantly enhance or detract from the long-ter m outcome of a BIGCBT program used in the treatment of panic disorder and agoraphobia. (C) 1997 Elsevier Science Ltd.