Combined Pharmacological and Psychological Treatments for Panic Sufferers: Michael J. Telch
Biological models and treatments of panic disorder and agoraphobia have enjoyed a tremendous surge in popularity, as evidenced by both the amount of recent media coverage and empirical research devoted to the topic. A recent overview of progress in psychiatry published in the Journal of the American Medical Association was devoted almost exclusively to the topic of panic (Freedman & Glass, 1984). Several different lines of empirical findings have been cited to support the thesis that panic disorder stems from an underlying biological dysfunction. These include (a) research pointing to the effectiveness of several classes of medications in suppressing panic (Sheehan, 1982), (b) panic provocation studies suggesting that sodium lactate precipitates attacks in panic disorder patients but rarely in controls (Appleby, Klein, Sachar, & Levitt, 1981; Liebowitz et al., 1984; Pitts & McClure, 1967), (c) the unusual age-of-onset distribution (Sheehan, 1982), and (d) the higher concordance rate in monozygotic than in dizygotic twins (Crowe, Pauls, Slymen, & Noyes, 1980). A review of these data is beyond the scope of this chapter and the reader is referred to Shear (this volume) for further information. A critical analysis of the empirical findings that support biological models of panic may be found in an excellent discussion and critique of these models by Margraf, Ehlers, and Roth (1986a).