Agoraphobia is sometimes treated in connection with panic disorder. If someone has agoraphobia for a year, it may continue for many years unless it is treated. The two main types of treatment for agoraphobia are:
- psychological therapy
- medication
Before starting any form of treatment for agoraphobia, your GP or psychiatrist (mental health specialist) will discuss all of the options with you. They will outline the advantages of each type of treatment with you, and they will also make you aware of any possible risks or side effects.
Different treatments will suit different people, so you may need to try a few before finding one that suits you. The treatment that is recommended for you will depend on the severity of your condition, you general health and your personal preferences.
The various psychological and medicinal treatments for agoraphobia are discussed in more detail below.
Psychological therapy
Psychological therapy has proven long-term benefits, and is the recommended form of treatment for people with panic disorder (with or without agoraphobia). If you have psychological therapy for panic disorder, it will usually be in the form of cognitive behavioural therapy.
Cognitive behavioural therapy (CBT)
CBT is thought to be one of the most effective forms of treatment for panic disorder with or without agoraphobia. CBT is a type of psychotherapy that is based on the principle that the way you feel is partly dependent on the way you think about things. CBT teaches you to behave in ways that challenge negative thoughts.
Your therapist will also be able to teach you ways of changing your behaviour, which should make it easier for you to deal with future panic attacks. For example, they may be able to show you breathing techniques that you can use to help keep you calm during the stress of a panic attack.
The National Institute for Health and Clinical Excellence (NICE) recommends 7–14 hours of CBT to be completed within a period of four months. Your treatment will usually involve having a weekly one-to-two hour session.
See the Health A-Z topic about Cognitive behavioural therapy for more information about this form of treatment.
Exposure therapy
Exposure therapy is another type of psychotherapy that is sometimes used to treat agoraphobia. It involves being gradually exposed to the object or situation that is feared, and using relaxation techniques to help reduce anxiety.
Support groups
Charity organisations such as Anxiety Care UK can provide useful information and advice about how to manage your agoraphobia effectively. They are also able to put you in touch with other people who have similar experiences of the condition.
Medication
Medication is sometimes used in combination with CBT to help treat the symptoms of agoraphobia. Medicines that may be used to treat agoraphobia include:
- antidepressants
- selective serotonin reuptake inhibitors (SSRIs)
- tricyclic antidepressants
- beta-blockers
Antidepressants
Antidepressants are often associated with depression, but they can also be used to treat other psychological conditions.
Antidepressants can take between two to four weeks before they become effective. Therefore, if you are prescribed antidepressants, you should continue to take them even if you feel that they are not working. Only stop taking prescribed medication if your GP specifically advises you to do so.
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that work by increasing the level of a chemical in your brain called serotonin.
SSRIs are the most commonly prescribed form of antidepressant for treating phobias. They are usually started at a low dose before gradually being increased as your body begins to adjust to the medicine.
Common side effects of SSRIs include:
- nausea
- headaches
- low sex drive
- blurred vision
- diarrhoea or constipation
- dizziness
- dry mouth
- loss of appetite
- sweating
- feeling agitated
- insomnia (being unable to sleep)
- abdominal (stomach) pain
When you first start to take SSRIs, your feelings of panic and anxiety may seem to get worse. In most cases this is only temporary and you will usually find that your symptoms start to return to normal levels within a few days of taking the medicine.
However, you should speak to your GP if you feel that your symptoms have got worse and that they are not showing signs of returning to normal levels after a few days. Contact your GP if you experience side effects after taking SSRIs that become troublesome and do not ease.
After you start to take a SSRI, visit your GP after two, four, six and 12 weeks so that they can check your progress and whether you are responding to the medicine. Not everyone responds well to antidepressant medicines, so it is important that your progress is carefully monitored.
If your GP feels that it is necessary, you may require regular blood tests or blood pressure checks when taking antidepressant medication. If after 12 weeks of taking the medication you do not show any signs of improvement, your GP may prescribe an alternative SSRI to see whether it is more effective.
See the Health A-Z topic about SSRIs for more information about this type of treatment.
Tricyclic antidepressants
If SSRIs do not improve your symptoms after a 12-week course, or if they are not suitable for you, your GP may prescribe a different type of antidepressant for you.
Tricyclic antidepressants work in a similar way to SSRIs. They regulate the levels of certain chemicals in your brain (noradrenaline and serotonin), which has a positive effect on your feelings and mood.
The two tricyclic antidepressants that are often prescribed are:
Tricyclic antidepressants are not addictive.
SSRIs are usually prescribed before tricyclic antidepressants because they have fewer side effects. However, common side effects of tricyclic antidepressants include:
- constipation
- difficulty urinating
- blurred vision
- dry mouth
- weight gain or weight loss
- drowsiness
- sweating
- lightheadedness
- skin rash
The side effects should ease after 7–10 days as your body begins to get used to the medication. However, contact your GP if they are troubling you.
Beta-blockers
Beta-blockers are a type of medication that can control symptoms of anxiety, such as sweating and trembling.
Beta-blockers work by slowing down your heart rate and the force of your heart. This reduces the pressure at which the blood is pumped out of your heart and around your body.
Common side effects of beta-blockers include:
- weakness
- dizziness
- cold hands
- fatigue
Beta-blockers are not usually recommended for people with asthma or diabetes because they may make the symptoms of these conditions worse.
Beta-blockers can also interact with other medicines, causing possible adverse side effects. Therefore, check with your GP or pharmacist before taking other medicines in combination with beta-blockers.
It is important that you do not stop taking beta-blockers without consulting your GP. Stopping this medication suddenly will lead to side effects, such as a rise in blood pressure or an angina attack.
See the Health A-Z topic about Beta-blockers for more information and advice about this type of medication.
