Fluvoxamine, placebo, and cognitive behaviour therapy used alone and in combination in the treatment of panic disorder and agoraphobia

Citation

Sharp DM, Power KG, Simpson R, Swanson V, Moodie E, Anstee JA & Ashford JJ (1996) Fluvoxamine, placebo, and cognitive behaviour therapy used alone and in combination in the treatment of panic disorder and agoraphobia. Journal of Anxiety Disorders, 10 (4), pp. 219-242. https://doi.org/10.1016/0887-6185%2896%2900008-4

Abstract
One hundred and ninety patients meeting DSM-III-R criteria for panic disorder with or without agoraphobia were randomly allocated to (a) Fluvoxamine, (b) placebo, (c) Fluvoxamine + cognitive behaviour therapy, (d) placebo + cognitive behaviour therapy, or (e) cognitive behaviour therapy alone. Patients were treated over 13 weeks and all participated in nine sessions plus follow-up at 6 months. Numbers in each group were as follows-(a) Fluvoxamine: entered n = 36, completed n = 29, attended follow-up n = 23; (b) placebo: entered n = 37, completed n = 28, attended follow-up n = 21; (c) Fluvoxamine + cognitive behaviour therapy: entered n = 38, completed n = 29, attended follow-up n = 24; (d) placebo + cognitive behaviour therapy: entered n = 36, completed n = 33, attended follow-up n = 30; (e) cognitive behaviour therapy: entered n = 43, completed n = 30, attended follow-up n = 28. A balance across treatments for therapist contact was attempted. A fixed-dose medication regimen was used with patients taking 150mg Fluvoxamine per day. A range of process and outcome measures both therapist- and patient-rated was used. Outcome at treatment end point and at 6-month follow-up was assessed in terms of both statistical and clinical significance and revealed that all active treatments showed improvement over time. This improvement was better preserved over follow-up in those groups receiving cognitive behaviour therapy (Groups c, d, and e) with these groups showing larger proportions of patients continuing to achieve predetermined criteria of clinically significant change on the Hamilton Anxiety Scale, Kellner and Sheffield Symptom Rating Test, and the Fear Questionnaire-Agoraphobia Scale at 6-month follow-up than those of the medication-alone groups (Groups a and b). The largest and most consistent treatment gains were evidenced by the cognitive behaviour therapy (Group e) and the Fluvoxamine + cognitive behaviour therapy (Group c) groups, with the latter showing these gains 2 weeks earlier in treatment, at Day 28 rather than Day 42.

Journal
Journal of Anxiety Disorders: Volume 10, Issue 4