Combining Cognitive-Behavioral Therapy and Pharmacotherapy for the Treatment of Panic Disorder

2006 ◽  
Vol 20 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Jasper A. J. Smits ◽  
Conall M. O’Cleirigh ◽  
Michael W. Otto
Keyword(s):  
Panic Disorder ◽  
Combination Treatment ◽  
Behavioral Therapy ◽  
Combined Treatment ◽  
Treatment Strategies ◽  
Cognitive Behavior ◽  
Short Term ◽  
Medication Treatment ◽  
Novel Approaches

This article focuses on the role of combination treatment strategies in the management of panic disorder (PD). Despite short-term benefits, there is not consistent evidence for a longer-term advantage of combined treatment over cognitive-behavior therapy alone. In discussing this result, we place emphasis on ways in which medication treatment may interfere with the learning of safety in relation to feared cues in PD. These considerations are placed in the context of animal and human studies of factors that interfere with the extinction of fears. Strategies to overcome this interference are also discussed as are novel approaches to combination treatment.

Do Medications Matter in the Context of Cognitive Behavior Therapy for Panic Disorder?

2005 ◽  
Vol 19 (4) ◽  
pp. 347-354 ◽  
Author(s):  
Norman B. Schmidt ◽  
Julia D. Smith
Keyword(s):  
Panic Disorder ◽  
Cognitive Behavioral Therapy ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavior ◽  
Medication Dose ◽  
Medication Status ◽  
Higher Doses

Patients with panic disorder are frequently medicated when they participate in psychotherapy such as cognitive behavioral therapy (CBT). The present study examined the effects of overall medication status, medication type (benzodiazepine versus antidepressant), and medication dose in a large sample of patients with panic disorder (N = 178) participating in CBT. Overall, medications exhibited very little effect on outcome. After controlling for the effects of CBT, however, taking higher doses of antidepressants was associated with poorer end-state functioning. Results are discussed in relation to better understanding the role of combining psychopharmacological and psychosocial treatments for panic disorder.

Quality of Life and Treatment Outcome in Panic Disorder: Cognitive Behavior Group Therapy Effects in Patients Refractory to Medication Treatment

2006 ◽  
Vol 75 (3) ◽  
pp. 183-186 ◽  
Author(s):  
Elizeth Heldt ◽  
Carolina Blaya ◽  
Luciano Isolan ◽  
Leticia Kipper ◽  
Betina Teruchkin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Outcome ◽  
Group Therapy ◽  
Panic Disorder ◽  
Cognitive Behavior ◽  
Medication Treatment

scholarly journals Diverse mechanisms and treatment strategies to confront fatigue in multiple sclerosis: A systematic review

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 563
Author(s):  
Sumanth Khadke ◽  
tehmina siddique
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Reviews ◽  
Observational Studies ◽  
Behavioral Therapy ◽  
Combined Treatment ◽  
Cochrane Review ◽  
Treatment Strategies ◽  
Individual Treatment ◽  
Positive Effects ◽  
Positive Effect

Background: Firm conclusions about the applicability of treatment methods other than pharmacotherapy in treating fatigue in multiple sclerosis (MS) remain elusive. Our objective is to synthesize and review the epidemiological literature systematically and find an effective therapeutic plan for fatigue. The effect of individual treatment and combined treatment strategies are studied. Methods: An electronic database search included EBSCO, PubMed, SCIENCE DIRECT and Scopus from January 1, 2013, to September 30, 2018. Search terms used are “Fatigue AND Multiple sclerosis AND therapy”. The articles included in the study are open access, published in last five years, not restricted to region and language. The search included randomized controlled trials (RCTs), observational studies, and systematic reviews. Results: We included 13 systematic reviews, 10 RCTs and 7 observational studies. A Cochrane review on 3206 patients showed exercise therapy to have a positive effect on fatigue in RRMS patients. The EPOC trial showed switching interferon therapy or glatiramer to fingolimod showed improved fatigue levels. The FACETS trial showed incorporating behavioral therapy to ongoing recommended therapy is beneficial. Few observational studies demonstrated that fatigue is influenced by pain, mood problems, and depression. Conclusions: The diverse pathology of fatigue related to MS is important in understanding and quantifying the role of each causal factor. Evidence reveals a positive effect on fatigue levels of RRMS patients with regular CBT and exercise-based combination therapy. Progressive forms of the disease have the worst prognosis. Individually aerobic exercises, behavioral therapy and pharmacotherapy have positive effects. A modified amalgamation of the same is a better hope for MS patients.

The spectrum of generalised anxiety in clinical practice: the role of short-term, intermittent treatment∗

1998 ◽  
Vol 173 (S34) ◽  
pp. 49-54 ◽  
Author(s):  
K. Rickels ◽  
E. Schweizer
Keyword(s):  
Family Practice ◽  
Treatment Strategies ◽  
The Other ◽  
Intermittent Therapy ◽  
Generalised Anxiety Disorder ◽  
Intermittent Treatment ◽  
Short Term ◽  
Dsm Iv ◽  
Spectrum Disorders

Background DSM–IV generalised anxiety disorder (GAD) has a high lifetime prevalence, but subthreshold anxiety states are even more common, particularly in family practice.Method Generalised anxiety is conceptualised as a spectrum of disorders, with transient anxiety at one end and GAD at the other.Results Based on longterm experience with family practice patients, the authors suggest that most anxious patients, wherever on this continuum they are placed, could be treated with short-term, possibly intermittent, rather than chronic anxiolytic therapy. Data are presented which show that 50% of chronic GAD patients are only in need of such short-term intermittent therapy.Conclusions Further clinical research is needed to refine short-term, intermittent treatments for anxiety spectrum disorders, to make effective treatments available to those suffering from anxiety but falling short of diagnostic criteria for GAD, and to target more effectively the different treatment strategies.

The New ABCs: A Practitioner's Guide to Neuroscience-Informed Cognitive-Behavior Therapy

2015 ◽  
Vol 37 (3) ◽  
pp. 206-220 ◽  
Author(s):  
Thomas A. Field ◽  
Eric T. Beeson ◽  
Laura K. Jones
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Behavioral Therapy ◽  
Physiological Responses ◽  
Cognitive Behavioral ◽  
Cognitive Behavior ◽  
Therapy Model ◽  
The Impact

Cognitive-behavioral therapy models are evolving to take into account the impact of physiological responses on client distress and the secondary role of conscious cognitions and beliefs in perpetuating distress and dysfunction. This article presents an accessible and practical description of a neuroscience-informed cognitive-behavior therapy model, in the hope that readers will learn how to apply this model in practice.

Psychosocial Approaches to the Treatment and Prevention of Bipolar Disorder

2016 ◽  
pp. 489-498
Author(s):  
Noreen A. Reilly-Harrington
Keyword(s):  
Bipolar Disorder ◽  
Behavioral Therapy ◽  
Treatment Strategies ◽  
Psychosocial Treatment ◽  
Future Research ◽  
Pediatric Bipolar Disorder ◽  
Treatment And Prevention ◽  
Social Rhythm ◽  
Psychosocial Approaches

Over the past two decades, adjunctive psychosocial treatments for bipolar disorder have been shown to hasten recovery, reduce relapse, and improve patients’ medication adherence, functioning, and quality of life. This chapter reviews four of the most widely studied psychosocial approaches for bipolar disorder: psychoeducation, cognitive-behavioral therapy (CBT), family-focused treatment (FFT), and interpersonal and social rhythm therapy (IPSRT). Core treatment strategies for each modality are presented, and key outcome studies are reviewed. The role of psychosocial treatment in pediatric bipolar disorder and in the prevention of bipolar disorder in youth at high risk for bipolar disorder is also presented. Suggestions for future research and the critical need for dissemination are also briefly discussed.

The role of therapist and patient in-session behavior for treatment outcome in exposure-based cognitive behavioral therapy for panic disorder with agoraphobia

2018 ◽  
Vol 75 (4) ◽  
pp. 614-626 ◽  
Author(s):  
Lisa M. Maiwald ◽  
Yvonne M. Junga ◽  
Thomas Lang ◽  
Romina Montini ◽  
Michael Witthöft ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Panic Disorder ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral

Target therapies plus somatostatin analogues in NETs: a network meta-analysis

2021 ◽  
Author(s):  
Sara Pusceddu ◽  
Antonio Facciorusso ◽  
Luca Giacomelli ◽  
Natalie Prinzi ◽  
Francesca Corti ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Combination Therapy ◽  
Meta Analysis ◽  
Treatment Options ◽  
Combined Treatment ◽  
Secondary Analysis ◽  
Treatment Strategies ◽  
Progression Free Survival ◽  
Somatostatin Analogues

Although combination therapy is not recommended in patients with gastro-entero-pancreatic (GEP) neuroendocrine tumors (NETs), this strategy is widely used in clinical practice. This network meta-analysis of randomized trials evaluates targeted therapies and somatostatin analogues in GEP advanced NETs, either alone or in combination, comparing the efficacy of different single or combined treatment strategies in terms of progression-free survival (PFS). Interventions were grouped as analogues, everolimus, everolimus plus SSAs, sunitinib and placebo. In a secondary analysis, we also assessed the efficacy of individual specific pharmacological treatments versus placebo or each other. From 83 studies identified, 8 randomized controlled trials were selected, with a total of 1849 patients with either functioning or non-functioning NETs. The analysis confirmed the superiority of all treatments over placebo (HR ranging from 0.34, 95% CI: 0.24–0.37 with the combination of everolimus plus SSAs to 0.42, 0.31–0.57 with the analogues; moderate quality of evidence). On ranking analysis, the combination of everolimus plus SSA (P score=0.86) and then everolimus alone (P score=0.65) ranked highest in increasing PFS. On comparative evaluation of different interventions, pasireotide (P score=0.96) and everolimus+octreotide (P score=0.82) ranked as the best pharmacological treatment options. Our findings support the use of combination therapy in the treatment of functioning and non-functioning GEP NETs. The role of pasireotide should be explored in selected subgroups of patients. Last, the combination of everolimus and octreotide appears promising and should be more widely considered in clinical practice.

The Role of Psychophysiological Hyperventilation Assessment in Cognitive Behavior Therapy

1989 ◽  
Vol 3 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Robert Fried ◽  
William L. Golden
Keyword(s):  
Panic Disorder ◽  
Behavior Therapy ◽  
Behavioral Treatment ◽  
Cognitive Behavior ◽  
Behavioral Strategies ◽  
Cognitive Coping ◽  
Breathing Retraining ◽  
Psychophysiological Disorders ◽  
Clinical Problems

Common clinical problems including anxiety, panic disorder, and agoraphobia, and psychophysiological disorders including migraine and Raynaud’s disease have been shown to be related to, or exacerbated by, hyperventilation. Demonstrating the connection between the symptoms and breathing has been reported to enhance the effects of behavioral treatment methods including breathing retraining and cognitive coping strategies. The reported hazards of the hyperventilation challenge additionally make the use of a psychophysiological hyperventilation profile (PHVP) a safer adjunct to cognitive behavioral strategies.

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