17-23 No interaction with antidepressants was found in five studies/24’28 Short-term positive interaction and long-term negative interaction of exposure in vivo with high doses of alprazolam (6

mg) was found by Marks et al29 and Wardle et al.30 Short-term positive interaction of exposure in vivo with low doses of diazepam (<30 mg) was found in a controlled study. However, there was a transient withdrawal syndrome. No negative long-term effects.31 Short-term positive interaction of CBT with low doses of buspirone (<30 mg) on agoraphobia and generalized anxiety was demonstrated Inhibitors,research,lifescience,medical in a controlled study. No withdrawal syndrome and no long-term negative effects appeared. The effect, of buspirone on agoraphobia correlated with its effects on depressive cognition. Buspirone's action on agoraphobic behaviors is probably mediated by the reduction of both anxiety and depression.32 CBT facilitated BDZ withdrawal

in two Inhibitors,research,lifescience,medical controlled studies.33,34 Relaxation in panic disorder and agoraphobia CT appeared to be superior to Jacobson’s relaxation in one trial.35 In a 2-year follow-up study, Craske et al35 suggested that Jacobson’s relaxation could even impede the positive effects of BT. Clark et al36 found that CBT (84%) was superior to relaxation (40%), imipramine with a maximum dose of 300 mg/day (42%), and a waiting list. The follow-up of this study was 1 Inhibitors,research,lifescience,medical year. At this point, all intention-to-treat groups received self-exposure Inhibitors,research,lifescience,medical instructions. This study confirmed the superiority of CBT over relaxation and also suggested that imipramine, the reference drug,

was neither the only effective treatment, nor the most efficient. Applied relaxation1-3 has been found to be as effective as CBT in panic disorder with agoraphobia. However, it. contains cognitive coping strategies, as well as exposure assignments. Accordingly, the applied relaxation format is more a variant, of CBT than a pure relaxation technique. This is confirmed by the fact that applied relaxation appeared better than Jacobson’s relaxation in one controlled trial.37 Nevertheless, applied relaxation Inhibitors,research,lifescience,medical was superior to a waiting list, but inferior to CT in another trial dealing with panic disorder without agoraphobia.38 ST in panic disorder In a controlled study, Beck et al39 reported a rate of 71 % panic-free patients after 8 weeks of CT versus 25% after 8 weeks of ST. It is worth noting that 94% of the patients who were randomized to ST chose to have CT after much ST. At. a 1-year follow-up 87% of the patients who had CT were panic-free versus 79% in the group who had ST first, and then CT. Beck et al’s39 DAPT secretase cost outcomes were at variance with those of Shear et al’s40 controlled study, which found at. a. 6-month follow-up that CT and ST demonstrated positive and equivalent effects on panic attacks. Psychodynamic therapy in panic disorder To our knowledge, there is only one controlled study concerning panic disorder.