Key result
Combined CBT and pharmacotherapy is linked to altered HRV and symptom improvement in panic disorder.
Why the study?
Heart rate variability characteristics in panic disorder patients before and after combined antidepressant and CBT treatment were not well characterized.
Does a 6-week treatment with antidepressants and CBT improve heart rate variability in patients with pharmacoresistant panic disorder?
Cohort (n=49)
Open-label
Does a 6-week treatment with antidepressants and CBT improve heart rate variability in patients with pharmacoresistant panic disorder?
Combination therapy with antidepressants and CBT in patients with pharmacoresistant panic disorder improves clinical symptoms and shows a tendency to increase previously lowered autonomic power as measured by heart rate variability.
Combination CBT plus antidepressants improved symptoms in pharmacoresistant panic disorder; leaves open whether HRV tracks treatment response.
We assessed HRV (heart rate variability) in 31 patients with panic disorder before and after 6-weeks treatment with antidepressants and CBT and 18 controls. Patients were regularly assessed weekly on the CGI, BAI and BDI. HRV was assessed during 3 positions. Thirty one pharmacoresistant panic disorder patients entered a 6-week open-label treatment study. A combination of CBT and pharmacotherapy proved to be the effective treatment. Patients significantly improved in all rating scales. There were highly statistical significant differences between panic patients and control group in all components of power spectral analysis in 2nd (VLF, LF and H in supine) and in two component of 3rd (LF and HF in standing) positions. There was also statistically significant difference between these two groups in LF/HF ratio in supine position (2nd). We have found statistically significant differences in HRV frequencies between before and after CBT program in VLF in standing position. We have also found statistically significant differences in HRV frequency ratios in the third position in case of decrease VLF + LF / HF ratio. We can also see decreasing activity in VLF and LF band in standing position in1st measurement and an increase in VLF and LF band in standing position in 2nd measurement. Conclusions These findings demonstrate a lower autonomic power in panic disorder patients and tendency to increase it during the treatment. Supported by: Project IGA MZ ČR NS10301-3/2009
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Diveky et al. (2013) conducted a cohort in Panic disorder (n=49). Antidepressants and CBT vs. Baseline and healthy controls was evaluated on Heart rate variability (HRV). A 6-week combination of CBT and pharmacotherapy in 31 patients with panic disorder significantly improved clinical rating scales and altered heart rate variability.
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