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The British Journal of Psychiatry 174: 205-212 (1999)
© 1999 The Royal College of Psychiatrists

Randomised placebo-controlled trial of moclobemide, cognitive- behavioural therapy and their combination in panic disorder with agoraphobia

B Loerch, M Graf-Morgenstern, M Hautzinger, S Schlegel, C Hain, J Sandmann and O Benkert
Department of Psychiatry, University of Mainz, Germany.

BACKGROUND: In the treatment of panic disorder with agoraphobia, the efficacy of pharmacological, psychological and combined treatments has been established. Unanswered questions concern the relative efficacy of such treatments. AIMS: To demonstrate that moclobemide and cognitive- behavioural therapy (CBT) are effective singly and more effective in combination. METHOD: Fifty-five patients were randomly assigned to an eight-week treatment of: moclobemide plus CBT; moclobemide plus clinical management ('psychological placebo'); placebo plus CBT; or placebo plus clinical management. RESULTS: Comparisons between treatments revealed strong effects for CBT. Moclobemide with clinical management was not superior to placebo. The combination of moclobemide with CBT did not yield significantly better short-term results than CBI with placebo. The CBT results remained stable during a six-month follow- up, although a substantial proportion of patients treated with placebo plus CBT needed additional treatment. CONCLUSIONS: CBT was highly effective in the treatment of panic disorder with agoraphobia and reduced agoraphobia to levels that were comparable to those of non- clinical controls.


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Copyright © 1999 The Royal College of Psychiatrists.