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February 1983

Treatment of PhobiasI. Comparison of Imipramine Hydrochloride and Placebo

Author Affiliations

From the Department of Psychiatry, Long Island Jewish-Hillside Medical Center, Glen Oaks, NY. Drs Klein and Ross are now with the New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York.

Arch Gen Psychiatry. 1983;40(2):125-138. doi:10.1001/archpsyc.1983.01790020019002

• In a controlled-outcome study of phobias, 218 adult phobic patients (147 women and 71 men) received a course of 26 weekly treatment sessions that consisted of behavior therapy (BT) and imipramine hydrochloride, BT and placebo, or supportive psychotherapy and imipramine. The BT consisted of systematic desensitization using fantasy and assertiveness training. Patients were classified as agoraphobic, mixed phobic, or simple phobic. Although the conditions of most patients in each group showed moderate to marked improvement, the effects of imipramine were significantly superior to those of placebo in patients with spontaneous panic attacks, ie, patients with agoraphobia or mixed phobia. In patients with simple phobia, who do not experience spontaneous panic, there was not a significant difference between imipramine and placebo. This study clearly distinguished those phobic patients who experienced spontaneous panic from those who did not in terms of pharmacologic benefit.