Exposure therapy for panic disorder and agoraphobia in the context of existing antidepressive medication

Background: Cognitive behavioral therapy (CBT) and pharmacotherapy with antidepressants are both a highly effective treatment for agoraphobia and/or panic disorder; however, a combination of CBT and antidepressants is under debate due to potentially unfavorable interference effects. The associations of existing antidepressant medication with panic and agoraphobia symptom burden and their change in the context of a structured 5-week day hospital and exposure-focused treatment in a naturalistic setting were investigated. Methods: Out of a total of n=488 patients medication use during treatment was retrospectively determined for n=380: n=100 (26.3%) were taking antidepressants of different drug classes. Calculations were performed using multiple linear regression analysis, t-tests, response analyses, and chi(2)-tests. Results: Patients with existing antidepressant medication more often met the criteria for comorbid depressive disorder (p<0.001). The measure of symptom change and treatment response rates did not differ between patients with and without antidepressants with respect to anxiety symptoms. Discussion: In the context studied, patients with and without existing antidepressant medication benefited equally from CBT with respect to anxiety symptoms.