The most effective treatments of panic disorder (PD) are serotonin selective reuptake inhibitors (SSRI) and cognitive-behavioral psychotherapy (CBT).

Aim was to compare efficacy of SSRI, CBT and combined therapy (CT).

Forty patients (aged 25 to 50 years) with panic disorder were randomly assigned to one of the three treatment groups: CBT (30 hours, or 4 weeks), SSRI (paroxetine 20 - 30 mg daily, 24 weeks), or CT (both of the abovementioned together). All patients were followed for 24 weeks. Symptoms were assessed using Clinical Global Impression scale, Spilberger State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI) and Minnesota Multiphasic Personality Inventory (MMPI).

At week 24, clinical improvement was reached in 61.5% of patients in the SSRI group, in 78.6% in the CBT group and in 92.3% in the CT group. Significant reduction (p<0.05) of the scores of STAI, BDI, and MMPI Hypochondriasis, Depression, Paranoia, Psychasthenia and Schizophrenia scales were registered also in all the three groups. Besides there were differences between CBT and SSRI MMPI profiles – increase (p<0.01) of Masculinity-Femininity, decrease (p<0.05) of Social Introversion and marked trend to reduction (p=0.07) of Paranoia scores in CBT group.

CT seems to be more superior to either monotherapy in the management of PD, whereas clinical effects of SSRI and CBT are close to similar. Obviously, SSRI and CBT exert different influences on personality structure.