Agoraphobia treatment
Considering the problem of agoraphobia treatment, it is important to say that agoraphobia is fear of some places. Patients with agoraphobia are afraid to visit various locations and stay there because they experience significant fear that it will not be easy to flee from these sites in case of need. Taking into account that fear of open places is one of the most frequent phobic disorders agoraphobia treatment becomes a significant component in the activity of doctors.
Psychotherapy in agoraphobia treatment
The patients are strongly recommended staying in frightening situation daily so that anxiety achieved its maximum levels. Doctors think that it is better for the patient to gain advantage of the arising stress and anxiety instead of escaping from them. Determination and endurance are crucial factors in suppression phobia owing to this exposure. Thus, the patients are told to return to the situations, which they avoid because avoiding strengthens the disorder. Treatment of a choice in most cases is the behavioral psychotherapy combining an exposition to phobic situations with training to overcome the panic attacks and panic symptoms. In comparison with the use of exposures only, this combination gives more efficient long-term results, including strong and long lasting changes of avoidance behavior, prevention and reduction of phobic anxiety and panic attacks. However, the majority of patients continue to experience moderate uneasiness in situations in which symptoms had originally been most expressed. The prognosis of this kind of treatment may be more favorable in patients who had good family relationships before the treatment and is worse in those patients who experience chronic stress.
Pharmacotherapy in agoraphobia treatment
Anxiolytics can be used as specific means with the purpose of the urgent help to the patient before other kinds of treatment provide effect. Anxiolytics should not be used on the constant basis within more than several weeks because of the risk of dependence. Exception of this general rule is alprazolam (a drug of the benzodiazepine group, used in the treatment of anxiety) for agoraphobia treatment with often panic attacks, also known as panic disorder with agoraphobia. This agoraphobia treatment is usually discussed when considering the treatment of panic disorder as many researchers think that patients with panic disorder and the patients suffering from agoraphobia with panic symptoms need the same approaches.
Antidepressants are particularly effective in agoraphobia treatment and can be used for the treatment of accompanying depressive disorder. Many patients suffering from agoraphobia experience relief from treatment with antidepressants. Successful agoraphobia treatment with antidepressants relieves disturbances of sleep, decreased liveliness, attention, and concentration. They also can have therapeutic effect in patients who do not experience depression, but have often panic attacks. Imipramine has been most carefully investigated. Similar therapeutic effects were also observed with clomipramine. For the agoraphobia treatment with panic symptoms high doses of imipramine are used. If at low dosages the effect is not achieved, doses up to 225 mg daily may be applied, but only if the patient does not suffer from heart affection or other somatic disease. However, after the termination of the treatment with imipramine the high level of relapses is frequently observed. Monoamine oxidase inhibitors (MAOIs) also reduce symptoms of agoraphobia, but they are used less often than imipramine because they interact with other drugs and food. As well as in a case with imipramine, the level of relapses after the discontinuance of taking these preparations is high even if the treatment lasted many months.