Phenelzine and exposure in the treatment of phobias

A double-blind study was carried out on 40 agoraphobic and socially phobic patients, matched, then randomly assigned to one of four treatment groups; phenelzine-exposure, phenelzine-no exposure, placebo-exposure, and placebo-no exposure. Exposure consisted of encouraging the patient to face the phobic situation a predetermined number of times. Assessments, made at the beginning and end of 8 weeks of therapy and 8 weeks thereafter, showed that the phobia ratings of groups decreased significantly. The combined exposure group improved significantly more than the combined no exposure group during treatment. At 8 weeks follow-up there was some deterioration in the phenelzine-exposure and placebo-no exposure groups. Exposure, with or without phenelzine, was the superior treatment modality. The antiphobic effect of phenelzine was not supported, although it seemed to reduce subjective anxiety during exposure experiences. The possibility that effect of phenelzine is dose-related is discussed.