Friday, August 04, 2006

E-Therapy for Agoraphobia?

Can a software program treat agoraphobia as well as a live therapist?

Well, E-therapy for agoraphobia is now available. “Beating the Blues” is an interactive software program that provides cognitive-behavioral therapy for sufferers of anxiety and depression. “FearFighter” is another form of cognitive behavioral e-therapy for people with anxiety disorders and phobias.

To give you a quick review before describing the software, cognitive-behavioral therapy, or CBT, is the most effective treatment for agoraphobia according to research. It is a combination of cognitive and behavioral approaches to therapy.

Cognitive therapy focuses on identifying and correcting irrational thought patterns. In behavior therapy, a person with agoraphobia learns to face feared situations instead of avoiding them through one of two types of exposure therapy. The person can practice exposure to feared settings in small steps (as in systematic desensitization) or all at once (as in flooding).

Developed in the UK, Beating the Blues is designed to be a first-line treatment option for anxiety and depression, similar to live therapy. It is to be considered before medication. Right now it is not available for sale online, it is only available through health care professionals in the UK, US, Canada and Australia.

Beating the Blues uses interactive modules, animations and voice-overs to motivate and engage the user. A major feature is a series of filmed case studies of fictional patients who model the symptoms of anxiety and depression and help demonstrate the treatment by cognitive behavioral therapy.

During the 8-session program, users identify specific problems and realistic treatment goals. They work through cognitive modules which focus on the identification and challenge of automatic thoughts, thinking errors, distractions, core beliefs, and attributional styles.

Interwoven with these cognitive elements are problem-directed behavioral components where patients can work on any two of activity scheduling, problem solving, graded exposure, task breakdown, or sleep management according to their specific problems. The final module looks at action planning and relapse prevention.

FearFighter is available online, but only to users who are registered with health professionals in the UK. It offers cognitive-behavioral treatment for anxiety and panic disorders, phobias, obsessive-compulsive disorder, depression and post-traumatic stress disorder.

If you have agoraphobia, then e-therapy might be as effective (or more) than live therapy, or so a 2004 study suggested.

This study demonstrated the effectiveness of computerized cognitive-behavioral therapy (CBT) for treating anxiety and depression in a clinical setting.

For anxiety, computerized CBT was more effective than traditional CBT in more severe cases. The more severe the anxiety disorder, the more effective computerized CBT was in comparison with traditional CBT. Computerized CBT also led to greater satisfaction with treatment.

Tuesday, August 01, 2006

Pregnancy Risk Categories of Agoraphobia Meds

In this post, I will share a rating scale used to assess the potential risks of medication during pregnancy and then let you know where various anti-anxiety medications used for agoraphobia fall on the scale.

The United Stated Food and Drug Administration (FDA) has assigned pregnancy risk categories to medications. The pregnancy risk category reflects the medication's potential to cause birth defects.

While it is not advisable to take medications during pregnancy, some people have to. The following rating system, designed by the FDA, is designed to help you decide which medications are a fairly safe risk and which are not.

Drugs in Category A are generally considered safe to use in pregnancy while drugs in category X should be avoided unless it is absolutely necessary to take them.

Category A: Adequate studies in pregnant women have failed to show a risk to the fetus.

Category B: Either one of two scenarios:

1) Animal studies haven't shown a risk to the fetus, but controlled studies haven't been conducted on pregnant women; or

2) Animal studies have shown an adverse effect on the fetus but adequate studies in pregnant women have failed to show a risk to the fetus.

Category C: Animal studies have shown an adverse effect on the fetus, but adequate studies haven't been conducted in humans. The benefits to pregnant women might be acceptable despite potential risks.

Category D: The drug may cause risk to the fetus, but the potential benefits of use in pregnant women may be acceptable despite the risks (such as in a life-threatening situation or a serious disease for which safer drugs can't be used or are ineffective).

Category X: Studies in animals or humans show fetal abnormalities, or adverse reaction reports indicate evidence of fetal risk. The risks clearly outweigh potential benefits.

Now, here's how various anxiety medications rate:

Xanax is in category D

Buspar is in category B (Buspar takes a few weeks to start taking effect in the body but is a much safer anti-anxiety medication than most).

Librium is in category D

Valium is in category D

Ativan is in category D

Serax is in category D

Now here are the ratings of some anti-depressants commonly prescribed for panic attacks:

Anafranil is in category C

Lexapro is in category C

Prozac is in category C

Paxil is in category C

Zoloft is in category C

I hope this information has been helpful. This info has been taken from the Nursing 2007 Drug Handbook. Always consult your doctor before taking any type of prescription medication.