This Article  • References  • Full text PDF  • Correction  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Charlotte Marker Zitrin, MD; Donald F. Klein, MD; Margaret G. Woerner, PhD

Arch Gen Psychiatry. 1978;35(3):307-316.

Abstract
• In a controlled outcome study of phobias, 111 adult patients (69% women, 31% men) received a course of 26 weekly treatment sessions consisting of (1) behavior therapy and imipramine hydrochloride (2) behavior therapy and placebo, or (3) supportive psychotherapy and imipramine. Patients were classified as agoraphobic, mixed phobic, or simple phobic. The great majority of patients in all groups showed moderate to marked global improvement (70% to 86%, depending on rater). In agoraphobics and mixed phobics (both groups experiencing spontaneous panic attacks), imipramine was significantly superior to placebo. There was no difference between behavior therapy and supportive therapy, both resulting in high improvement rates (76% to 100%, depending on rater). In simple phobic patients, there was a high rate of improvement with all treatment regimens (72% to 93%, depending on rater), with no significant difference between imipramine and placebo or between behavior therapy and supportive therapy. Of 88 moderately to markedly improved patients followed up for one year after completing treatment, 83% maintained their gains and 17% relapsed. No patients showed symptom substitution. Eighteen percent of the patients receiving imipramine hydrochloride showed marked stimulant side effects on from 5 to 75 mg/day.

Author Affiliations
From the Long Island Jewish-Hillside Medical Center, Hillside Division, Glen Oaks, NY.

Footnotes
Accepted for publication April 18, 1977.

Reprint requests to Long Island Jewish-Hillside Medical Center, PO Box 38, Glen Oaks, NY 11004 (Dr Zitrin).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Antidepressant-induced jitteriness/anxiety syndrome: systematic review
Sinclair et al.
Br. J. Psychiatry 2009;194:483-490.
ABSTRACT | FULL TEXT  

The Loss of Serendipity in Psychopharmacology
Klein
JAMA 2008;299:1063-1065.
FULL TEXT  

Dose Discrepancies Between the Physicians' Desk Reference and the Medical Literature, and Their Possible Role in the High Incidence of Dose-Related Adverse Drug Events
Cohen
Arch Intern Med 2001;161:957-964.
ABSTRACT | FULL TEXT  

A Randomized Prospective Study Comparing Supportive and Dynamic Therapies: Outcome and Alliance
Hellerstein et al.
J. Psychother. Pract. Res. 1998;7:261-271.
ABSTRACT | FULL TEXT  

Suicide Attempts in Patients With Panic Disorder
Lepine et al.
Arch Gen Psychiatry 1993;50:144-149.
ABSTRACT  

Clomipramine and initial worsening in panic disorder: beyond the 'jitteriness syndrome'
Ramos et al.
J Psychopharmacol 1993;7:265-269.
ABSTRACT  

The Emergence of Suicidal Ideation and Behavior During Antidepressant Pharmacotherapy
Mann and Kapur
Arch Gen Psychiatry 1991;48:1027-1033.
ABSTRACT  

Follow-up Study of Patients With Panic Disorder
Judd et al.
Arch Gen Psychiatry 1991;48:860-861.
ABSTRACT  

Reconceptualizing Agoraphobia: A Case Study of Epistemological Bias in Clinical Research
Gelfond
Feminism Psychology 1991;1:247-262.
 

Imipramine in panic disorder. 1. Clinical response and pharmacological changes
Nutt and Glue
J Psychopharmacol 1991;5:56-64.
ABSTRACT  

Atypical Depression, Panic Attacks, and Response to Imipramine and Phenelzine: A Replication
Quitkin et al.
Arch Gen Psychiatry 1990;47:935-941.
ABSTRACT  

Treatment of Panic Disorder
Hayes
Journal of Pharmacy Practice 1990;3:233-240.
ABSTRACT  

Clinical and Medication Outcome After Short-term Alprazolam and Behavorial Group Treatment in Panic Disorder: 2.5-Year Naturalistic Follow-up Study
Nagy et al.
Arch Gen Psychiatry 1989;46:993-999.
ABSTRACT  

Panic Attacks Facilitating Recall and Mastery: Implications for Psychoanalytic Technique
Silber
J Am Psychoanal Assoc 1989;37:337-364.
ABSTRACT  

Relapse to Cocaine Abuse After Initiating Desipramine Treatment
Weiss
JAMA 1988;260:2545-2546.
ABSTRACT  

Alprazolam in Panic Disorder and Agoraphobia: Results From a Multicenter Trial: I. Efficacy in Short-term Treatment
Ballenger et al.
Arch Gen Psychiatry 1988;45:413-422.
ABSTRACT  

Interim Analyses and Publication of Clinical Trials
Paykel
Arch Gen Psychiatry 1986;43:613-613.
ABSTRACT  

Noradrenergic Function and the Mechanism of Action of Antianxiety Treatment: II. The Effect of Long-term Imipramine Treatment
Charney and Heninger
Arch Gen Psychiatry 1985;42:473-481.
ABSTRACT  

Adrenergic Function in Patients With Panic Anxiety
Nesse et al.
Arch Gen Psychiatry 1984;41:771-776.
ABSTRACT  

The Anxiety Disorders
BROWN et al.
ANN INTERN MED 1984;100:558-564.
ABSTRACT  

Panic-Induced Elevation of Plasma MHPG Levels in Phobic-Anxious Patients: Effects of Clonidine and Imipramine
Ko et al.
Arch Gen Psychiatry 1983;40:425-430.
ABSTRACT  

Treatment of Phobias: I. Comparison of Imipramine Hydrochloride and Placebo
Zitrin et al.
Arch Gen Psychiatry 1983;40:125-138.
ABSTRACT  

Imipramine and Brief Therapist-Aided Exposure in Agoraphobics Having Self-exposure Homework
Marks et al.
Arch Gen Psychiatry 1983;40:153-162.
ABSTRACT  

Treatment of Agoraphobia and Panic Attacks
Matuzas and Glass
Arch Gen Psychiatry 1983;40:220-222.
ABSTRACT  

Atypical Depression
Davidson et al.
Arch Gen Psychiatry 1982;39:527-534.
ABSTRACT  

Exposure Treatments for Focal Phobias: A Review
Linden
Arch Gen Psychiatry 1981;38:769-775.
ABSTRACT  

The Current Status of Behavior Therapy
Kazdin and Hersen
Behav Modif 1980;4:283-302.
ABSTRACT  

Treatment of Endogenous Anxiety With Phobic, Hysterical, and Hypochondriacal Symptoms
Sheehan et al.
Arch Gen Psychiatry 1980;37:51-59.
ABSTRACT  

Treatment of Agoraphobia With Group Exposure In Vivo and Imipramine
Zitrin et al.
Arch Gen Psychiatry 1980;37:63-72.
ABSTRACT  

Psychiatry
Freedman
JAMA 1979;241:1373-1375.
ABSTRACT