Psychiatria pre prax 3/2012

Agoraphobia and its treatment

Agoraphobia is a phobic-anxious syndrome where patients avoid situations or places in which they fear being embarrassed, or being unable to escape or get help if a panic attack occurs. Effective treatments for agoraphobia are available. The treatment of choice is cognitive behavioral therapy (CBT). CBT is the best studied non-pharmacological approach and can be applied to many patients, depending on its availability. Pharmacological interventions include the possible use of a variety of agents. Among antidepressant agents, SSRIs are generally well tolerated and effective for both anxious and depressive symptomatology, and these compounds should be considered the first choice for short-, medium- and long-term pharmacological treatment of agoraphobia. These drugs are also effective in the treatment of the frequently coexisting depressive symptomatology. High-potency benzodiazepines have been shown to have a rapid onset of anti-anxiety eect, having beneficial effects during the first few days of treatment, and are therefore useful for sh ort-term treatment; however, these drugs are not first-choice medications in the medium and long term because of the frequent development of tolerance and dependence phenomena.

Keywords: agoraphobia; cognitive behavioral therapy, benzodiazepines, antidepressants