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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.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Psychotherapy and a benzodiazepine combined for treating panic disorder

Panic disorder is characterised by the repeated occurrence of unexpected panic attacks, during which the individual experiences a strong fear with anticipation of death. These attacks are often accompanied by somatic symptoms such as palpitations, dyspnoea or faintness. Those suffering from panic disorder have persistent anticipatory fear of recurrent attacks and feel anxious even while they have no occurrence of panic attacks for a certain period. Panic disorder is strongly associated with an increased risk for agoraphobia and depression. The prevalence of panic disorder is reported to be around 2 to 3 percent in the general population. Two broad categories of treatment have been shown to be effective in treating panic disorder, one being pharmacotherapy with antidepressants or benzodiazepines, the other being psychotherapy. These treatments are often combined, yet the efficacy of combining psychotherapy and benzodiazepine for panic disorder is unclear, despite its widespread use. This review included randomised controlled trials comparing the combination of psychotherapy and a benzodiazepine with either the psychotherapy or the benzodiazapine alone for people with panic disorder. We were able to include only three trials in this review. Two could be used in the comparison of the combination of psychotherapy and benzodiazepine versus psychotherapy alone and one in the comparison of the combination with benzodiazepine. These comparisons involved just 166 patients and 77 patients, respectively. These small numbers make it difficult to detect any differences between combination treatments and either treatment alone. The trials which compared the combination of treatments with psychotherapy alone (both using behaviour therapy) indicated no differences in response between the two approaches, either during the intervention, at the end of the intervention, or at the last follow‐up time point. The trial which compared the combination of treatments with a benzodiazepine alone demonstrated no differences in response during the intervention. Although the combination of treatments appeared to be more effective than the benzodiazepine alone at the end of treatment, no significant differences were observed at the 7‐month follow‐up. Before evidence‐based treatment recommendations are possible, more randomised controlled trials are required, comparing the combination of psychotherapy and benzodiazepines with either treatment alone, and involving enough people to be able to detect a true difference between the treatments if one exists.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

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.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Valerian for anxiety disorders

Anxiety disorders are a very common mental health problem in the community. Most of the medications used to treat anxiety have side effects. Valerian is a phytotherapeutic medication frequently used for insomnia. The aim of this study was to investigate the efficacy and safety of valerian for anxiety disorders. Only one study was identified, involving 36 patients and comparing valerian with placebo and diazepam. This study found no significant differences in effectiveness between valerian and placebo, or between valerian and diazepam, for clinician‐rated anxiety symptoms, and that both valerian and diazepam were equally well tolerated by patients. However, additional studies with larger numbers of patients are necessary before drawing conclusions about the effectiveness and safety of valerian as a treatment option for anxiety disorders.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Adjustment to Cancer: Anxiety and Distress (PDQ®): Patient Version

Expert-reviewed information summary about the difficult emotional responses many cancer patients experience. This summary focuses on normal adjustment issues, psychosocial distress, and adjustment disorders.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: January 7, 2015

Systematic Reviews in PubMed

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