Should You Be on Meds, Psychotherapy or Both?

By John M Grohol PsyD

Time and time again we’re inundated in the media by ads for different medications that are supposed to help with this or that condition, including life-altering conditions such as depression and anxiety. But these ads rarely talk about what’s best for a person suffering from one of these disorders. They instead focus on how their medication, and theirs alone, is a treatment approach to ask your doctor about.

There’s nothing wrong with that, per se, except that the research shows time and time again that medication alone — virtually any medication you can name — in the treatment of a mental disorder is not nearly as effective as when it is combined with psychotherapy.

Which brings me to this study, a systematic review that included 21 randomized studies with over 1,700 subjects — Combined psychotherapy plus antidepressants for panic disorder with or without agoraphobia:

After the acute phase treatment, as long as the drug was continued, the superiority of the combination over either monotherapy appeared to persist. After termination of the acute phase and continuation treatment, the combined therapy was more effective than pharmacotherapy alone. [...]

Either combined therapy or psychotherapy alone may be chosen as first line treatment for panic disorder with or without agoraphobia, depending on patient preference.

This goes against the Common Wisdom and how doctors typically treat panic disorder. Why? Because panic disorder feels like a physical issue, because of its physical symptoms — heart racing, palpable anxiety, shortness of breath. But it’s not a physical disease — it’s a mental disorder that responds best to combined treatment with medication and psychotherapy.

If you’re only taking medication for panic disorder, you’re doing a disservice to yourself — it’ll take longer to feel better (to be without panic symptoms) and you’ll experience more panic symptoms.

The study is a part of the Cochrane database and was originally published in 2006.

Reference

Furukawa, T.A., Watanabe, N. & Churchill, R. (2006). Psychotherapy plus antidepressant for panic disorder with or without agoraphobia. British Journal of Psychiatry,188:305-12.

Dr. John Grohol is the CEO and founder of Psych Central. He has been writing about online behavior, mental health and psychology issues, and the intersection of technology and psychology since 1992.