Harvard Mental Health Letter

Combination therapy for panic disorder

Recent analyses reinforce the view that adding psychotherapy to medication improves outcomes.

Pharmacological treatment for panic disorder is well established. For several decades, the disorder has been successfully treated with either an anti-anxiety agent from the benzodiazepine class, an antidepressant, or a combination. Another option is cognitive behavioral therapy, the most effective psychotherapy for panic disorder.

But medication or psychotherapy, when used on their own, are not effective for everyone. About 50% to 70% of patients typically respond to medication or psychotherapy during the first few months of treatment. About 25% to 50% of patients who stop taking a medication, perhaps because of concern about sedation or other side effects, suffer a relapse within six months. In part, this may be due to abruptly stopping medications (especially benzodiazepines), which can give rise to an uncomfortable withdrawal or discontinuation syndrome.

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