Drugs and psychological treatments for agoraphobia/panic and obsessive-compulsive disorders: a review

Br J Psychiatry. 1988 Nov:153:650-8. doi: 10.1192/bjp.153.5.650.

Abstract

In the short term, both antidepressants and exposure therapy usually improve agoraphobia/panic (AP) and obsessive-compulsive (OC) disorders and are accepted by most patients; psychological methods omitting exposure are not consistently helpful. Antidepressants have a broad-spectrum rather than specific anti-agoraphobia/panic or anti-obsessive-compulsive action. For long-term efficacy, there is good evidence for the value of exposure, but none for drugs. Because of relapse on ceasing drugs, and their side-effects, medication is less useful as the first line of treatment for chronic agoraphobia/panic or obsessive-compulsive disorder than is the lastingly helpful approach of exposure. Antidepressants are worth trying when patients refuse or fail with exposure therapy, or are dysphoric.

Publication types

  • Review

MeSH terms

  • Agoraphobia / therapy*
  • Antidepressive Agents / therapeutic use
  • Fear*
  • Habituation, Psychophysiologic
  • Humans
  • Imipramine / therapeutic use
  • Obsessive-Compulsive Disorder / therapy*
  • Panic*
  • Phobic Disorders / therapy*
  • Psychotherapy
  • Time Factors

Substances

  • Antidepressive Agents
  • Imipramine