Combined Therapy for Anxiety Disorders

A most read article about combined pharmacotherapy and cognitive-behavioural therapy for anxiety disorders (including OCD) has been published in Journal of Current Opinion in Psychiatry and on the website Medscape. The abstract from Current Opinion in Psychiatry:

Purpose of review: Both pharmacotherapy and cognitive-behavioural therapy are effective treatments for anxiety disorders. The present editorial reviews the current status of combination treatments with a focus on randomized controlled trials, meta-analyses and reviews that have been published in the past 3 years. Recent findings: Recent studies on treatments combining pharmacotherapy and cognitive-behavioural therapy for anxiety disorders have found little benefit for combination therapies versus monotherapies. New investigations have explored the potential benefits of sequential treatments versus the concomitant ones as well as the use of cognitive enhancers as adjuncts to psychotherapy. Summary: Uncertainty exists as to whether the combination of cognitive-behavioural therapy and pharmacotherapy in the treatment of anxiety disorders is associated with greater overall efficacy than with either treatment when given alone. New ways for combining the two types of treatments are being investigated.

and the conlusion from the Medscape article:

In the acute phase, current treatments for anxiety disorders combining pharmacotherapy and CBT do not seem to be associated with greater overall efficacy than that achieved with either treatment when given alone. In the long-term treatment of anxiety disorders, combination treatments may be more effective than pharmacotherapy alone, but not more effective than CBT alone. New strategies for combining pharmacotherapy and CBT, such as the sequential administration of pharmacotherapy and CBT, the combination of virtual reality exposure therapy and pharmacotherapy or the use of cognitive enhancers in combination with CBT, have yielded promising results and should be investigated more fully in the years to come.

Sources:

Combined pharmacotherapy and cognitive-behavioural therapy for anxiety disorders. Current Opinion in Psychiatry. 20(1):30-35, January 2007. Pull, Charles B. Abstract.

Combined Pharmacotherapy and Cognitive-Behavioural Therapy for Anxiety Disorders, Medscape 2. february 2007. Article.

Charles B. Pull, Department of Neurosciences, Centre Hospitalier de Luxembourg, Luxembourg

Charles P Vega, MD, Associate Professor, Residency Director, Department of Family Medicine, University of California, Irvine

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