| Budget Amount *help |
¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000)
Fiscal Year 2011: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2010: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2009: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Research Abstract |
It is well known that combination of cognitive-behavioral therapy and pharmacotherapy(the combination therapy) for panic disorder(PD) with agoraphobia is effective. However, there has been little research on the most favorable drug for the combination therapy. The purpose of this study was to examine which drug for the combination therapy is best to improve symptoms of panic disorder with agoraphobia.
Out patients were recruited between October 2008 and March 2011 and assigned to pharmacotherapy at Showa university hospital. Pharmacotherapists were free to choose the drug for patients. We used Panic disorder severity scale(PDSS), Hamilton Rating Scale for Anxiety(HRSA), Global Assessment of Functioning Scale(GAF), Hospital Anxiety Depression Scale(HADS), Agoraphobic Cognitions Questionnaire(ACQ), Body Sensations Questionnaire(BSQ), Clinical Global Impression(CGI)-Severity & Improvement for assessment. Outcomes were assessed before(pretest) and after(protest : 12weeks) pharmacotherapy co
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mbined 10 times cognitive-behavioral group therapy(CBGT).
Forty-one patients improved significantly from pretest to posttest on PDSS for Japanese, which was primary outcome measure. At posttrearment, all scales improved significantly by Temporary use of benzodiazepines more than Regular use. We supposed that temporary using benzodiazepine is least disruptive to the combination therapy, while regular using benzodiazepine interferes with CBT, which works on frontal cortex. In contrast, using antidepressant, antipsychotic and moodstabilizer had little influence on outcomes in this study. PD with SSRI are changed the typical cognition of panic disorder faster than without SSRI, while both regular and temporary using benzodiazepine improved at the same time.
In summary, the results from our clinical trial provide support that the combination therapy is efficacious for panic disorder with agoraphobia. SSRI and a single dose of benzodiazepine are recommended for the combination therapy. SSRI can change the typical cognition of panic disorder faster. Temporary using benzodiazepine is more effective than regular using benzodiazepine at posttreatment of CBGT. Less
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