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Follow-up Study of Patients With Panic Disorder-Reply

Linda M. Nagy, MD; John H. Krystal, MD; Dennis S. Charney, MD; Scott W. Woods, MD
Arch Gen Psychiatry. 1991;48(9):861-862. doi:10.1001/archpsyc.1991.01810330085018
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In Reply.—  We appreciate the letter supporting our finding that the antipanic and antiphobic efficacy of combined alprazolam and behavioral therapy is sustained following shortterm treatment. We reemphasize that we could not address the comparative efficacy of one or both forms of treatment, as all our patients received both medication and behavioral treatment. However, our data do address the issue of what happens when drug therapy is withdrawn, in that several patients maintained treatment gains when not receiving medication, and the vast majority maintained treatment gains while receiving substantially reduced doses of alprazolam.Judd et al share interesting data regarding 12-month follow-up of patients with panic attacks treated with pharmacotherapy, some of whom also received behavioral therapy. It is unclear why 12 patients received adjunctive behavioral treatment. If treatments were not randomly assigned, it is likely that selection based on clinical features accounts for any differences between these groups. We also caution

REFERENCES

Telch MJ, Agras S, Taylor CB, Roth WT, Gallen C.  Combined pharmacological and behavioral treatment for agoraphobia . Behav Res Ther . 1985;;23:325-335.
Ballenger JC, Burrows GD, DuPont RL, Lesser IM, Noyes R, Pecknold JC, Rifkin A, Swinson RP.  Alprazolam in panic disorder and agoraphobia: results from a multicenter trial, I: efficacy in short-term treatment . Arch Gen Psychiatry . 1988;;45:413-422.
Nagy LM, Krystal JH, Woods SW, Charney DS.  Clinical and medication outcome after short-term alprazolam and behavioral group treatment in panic disorder: 2.5-year naturalistic follow-up study . Arch Gen Psychiatry . 1989;;46:993-999.
Nagy LM, Krystal JH, Charney DS, Merikangas KR, Woods SW. Long-term efficacy of imipramine in panic disorder. Presented at the 142nd annual meeting of the American Psychiatric Association; May 11, 1989; San Francisco, Calif. Abstract NR329.

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Telch MJ, Agras S, Taylor CB, Roth WT, Gallen C.  Combined pharmacological and behavioral treatment for agoraphobia . Behav Res Ther . 1985;;23:325-335.
Ballenger JC, Burrows GD, DuPont RL, Lesser IM, Noyes R, Pecknold JC, Rifkin A, Swinson RP.  Alprazolam in panic disorder and agoraphobia: results from a multicenter trial, I: efficacy in short-term treatment . Arch Gen Psychiatry . 1988;;45:413-422.
Nagy LM, Krystal JH, Woods SW, Charney DS.  Clinical and medication outcome after short-term alprazolam and behavioral group treatment in panic disorder: 2.5-year naturalistic follow-up study . Arch Gen Psychiatry . 1989;;46:993-999.
Nagy LM, Krystal JH, Charney DS, Merikangas KR, Woods SW. Long-term efficacy of imipramine in panic disorder. Presented at the 142nd annual meeting of the American Psychiatric Association; May 11, 1989; San Francisco, Calif. Abstract NR329.

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