Two-year follow-up of agoraphobics after exposure and imipramine

Abstract

Agoraphobic outpatients (45) were randomly assigned to treatment with imipramine or placebo, and also to brief therapist-aided exposure or relaxation. All patients did systematic self-exposure homework and recorded this in a diary. Of these patients, 40 were followed up 2 yr later with self-ratings and ratings by interviewers blind to their treatment conditions. Of the patients, .apprx. 2/3 remained improved or much improved in their phobias, with no significant difference between any of the 4 treatment conditions. Spontaneous panics also remained improved. The absence of an imipramine effect may reflect the lack of initial dysphoria (anxiety-depression) in this sample compared with other studies where drug effects were found. The post-treatment superiority (evident at wk 28) of patients who had therapist-aided exposure was no longer present at the 2 yr follow-up; the others had caught up, presumably because of their self-exposure homework.