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Am J Psychiatry 164:273-275, February 2007
doi: 10.1176/appi.ajp.164.2.273
© 2007 American Psychiatric Association
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A Comparison of Medication Side Effect Reports by Panic Disorder Patients With and Without Concomitant Cognitive Behavior Therapy

Sue M. Marcus, Ph.D., Jack Gorman, M.D., M. Katherine Shear, M.D., David Lewin, B.S., Jose Martinez, M.A., Susan Ray, M.S., Raymond Goetz, Ph.D., Serge Mosovich, M.D., Lauren Gorman, M.D., David Barlow, Ph.D., and Scott Woods, M.D.

OBJECTIVE: The authors assessed whether adding cognitive behavior therapy (CBT) to imipramine for patients with panic disorder decreased the severity of side effects and dropouts from side effects. METHOD: Data were analyzed for 172 panic disorder patients who were randomly assigned to receive imipramine alone, imipramine plus CBT, or placebo. Mixed-effects models were used to assess longitudinal differences among the treatment groups with respect to side effect burden and dropout rates during the acute, maintenance, and follow-up phases of treatment. RESULTS: Patients treated with imipramine plus CBT experienced less severe fatigue/weakness, dry mouth, and sweating and had a lower rate of dropout due to side effects compared with those treated with imipramine only. CONCLUSIONS: The addition of CBT to medication treatment with imipramine was associated with less severe side effects and fewer dropouts due to perceived side effects than treatment with imipramine alone.







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