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Obsessive, persistent, intense fear of open places.

PubMed Health Glossary
(Source: NIH - National Library of Medicine)

About Panic and Agoraphobia

People who have full-blown, repeated panic attacks can become very disabled by their condition and should seek treatment before they start to avoid places or situations where panic attacks have occurred. For example, if a panic attack happened in an elevator, someone with panic disorder may develop a fear of elevators that could affect the choice of a job or an apartment, and restrict where that person can seek medical attention or enjoy entertainment.

Some people's lives become so restricted that they avoid normal activities, such as grocery shopping or driving. About one-third become housebound or are able to confront a feared situation only when accompanied by a spouse or other trusted person. When the condition progresses this far, it is called agoraphobia, or fear of open spaces.

Early treatment can often prevent agoraphobia, but people with panic disorder may sometimes go from doctor to doctor for years and visit the emergency room repeatedly before someone correctly diagnoses their condition. This is unfortunate, because panic disorder is one of the most treatable of all the anxiety disorders, responding in most cases to certain kinds of medication or certain kinds of cognitive psychotherapy, which help change thinking patterns that lead to fear and anxiety...Read more about Panic Disorder NIH - National Institute of Mental Health

What works? Research summarized

Evidence reviews

The efficacy of couples-based interventions for panic disorder with agoraphobia

Bibliographic details: Byrne M, Carr A, Clark M.  The efficacy of couples-based interventions for panic disorder with agoraphobia. Journal of Family Therapy 2004; 26(2): 105-125

Psychological treatment of panic disorder with or without agoraphobia: a meta-analysis

This review found that a combination of exposure, relaxation training, and breathing-technique training was effective for treating panic disorder with or without agoraphobia, especially if treatment included homework during the intervention and a follow-up programme after it. There were limitations in the review, including weaknesses in the search and unexplained heterogeneity between studies, and the authors’ conclusions require cautious interpretation.

A meta-analysis of the efficacy of psycho- and pharmacotherapy in panic disorder with and without agoraphobia

This review assessed (cognitive) behavioural therapy ((C)BT) and pharmacological treatment for panic disorder and/or agoraphobia. The author's conclusions appeared to be that (C)BT reduced anxiety and depression and improved quality of life, while pharmacological treatments improved all symptoms. Poor reporting of the review methods, study details and study quality make it difficult to comment on the reliability of the author's conclusions.

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Summaries for consumers

Psychotherapy combined with antidepressants for panic disorder

Psychotherapy plus antidepressant treatment were compared with each of the two individual treatments alone for panic disorder. At the end of the acute phase treatment, the combined therapy was superior to psychotherapy or antidepressant treatment alone. After termination of active treatment, the combined therapy was superior to antidepressants alone and was as effective as psychotherapy alone. Either combined therapy or psychotherapy alone may be chosen as first line treatment for panic disorder with or without agoraphobia, depending on patient preference.

Azapirones versus placebo for panic disorder in adults

Panic disorder is common in the general population and is often associated with various psychiatric disorders. Azapirones are a class of drugs occasionally used in the treatment of panic disorder, although none has been approved by a regulatory agency for this purpose. They are associated with less drowsiness, psychomotor impairment, alcohol potentiation and potential for addiction or abuse. However, azapirones are not widely used for panic disorder. Evidence for their efficacy in treating panic disorder is unclear. It is important to find out if azapirones are effective and acceptable in the treatment of panic disorder.

Passiflora for the treatment of anxiety disorders in adults

Anxiety is a very common mental health problem in the general population. Passiflora, a herbal medicine, could be an option for treating anxiety if shown to be effective and safe. This review summarised the evidence from currently available studies on passiflora. Only two studies were eligible for inclusion, involving a total of 198 participants. One study showed that passiflora was as effective as benzodiazepines, with similar dropout rates between the two treatments. Given the lack of studies, it is not possible to draw any conclusions on the effectiveness or safety of passiflora in the treatment of anxiety disorders.

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More about Agoraphobia

Photo of an adult woman

Also called: Agoraphobic

Other terms to know:
Anxiety, Panic Disorder

Keep up with systematic reviews on Agoraphobia:


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