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

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 CBT 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. Declaration of interest Supported by Hoffmann LaRoche AG.