Treatment options for agoraphobia 

Treatment
Pros
Cons

Useful links

Self-help

Self-help techniques and lifestyle changes

Self-help techniques, such as slow, deep breathing and thinking positive thoughts, can sometimes prevent feelings of panic escalating.

Making simple lifestyle changes, such as exercising regularly, avoiding alcohol and drugs, and eating healthily, can also help improve your mood and reduce feelings of anxiety.

  • Better emotional control can often help improve confidence in stressful situations.
  • Lifestyle changes can also bring other important health benefits, such as reducing your risk of cancer and heart disease.
  • There's evidence that following this advice can help improve symptoms when combined with many of the treatments discussed below.
  • This type of advice may not be sufficient in treating moderate to severe agoraphobia.
  • People with more severe agoraphobia often use alcohol and drugs as a coping mechanism, and may find it difficult to stop.
  • People with an intense fear of leaving the house may find exercising difficult.

Psychological therapies

Guided self-help

Working through a short course or following a self-help manual or internet-based programme designed to provide practical advice about how to better cope with your feelings of anxiety.

  • Can often achieve impressive short-term results within five or six weeks.
  • There's no waiting list for gaining access to treatment.
  • Some people find this approach impersonal.
  • It may not be effective for more severe agoraphobia.
  • Some people can find it difficult to stay motivated without the input of a counsellor.
Cognitive behavioural therapy (CBT)

CBT is a talking therapy that aims to change unhelpful and unrealistic patterns of thinking to help you behave in a more positive way.

  • Proven to be clinically effective for treating many people with agoraphobia.
  • Access to CBT can be limited in some parts of the country and you may have to wait for treatment.
  • Can take up to three months before a significant improvement in symptoms is noticed.
  • May not be successful as a sole treatment in more severe cases, and often has to be combined with medication.
Applied relaxation and mindfulness

Mindfulness is based on the premise that people with agoraphobia and related panic disorder have lost their ability to relax. The purpose of therapy is to "relearn" how to relax.

  • Proven to be effective for improving feelings of anxiety and depression.
  • Reducing stress levels through mindfulness and relaxation can improve physical health as well as mental wellbeing.
  • As with CBT, access to applied relaxation and mindfulness can be limited in some parts of the country.
  • May not be successful as a sole treatment in more severe cases, and often has to be combined with medication.

Medication

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are a type of medication originally used to treat depression, which can also help relieve feelings of anxiety, panic and obsessional thoughts.

  • Can often prove effective for treating severe agoraphobia when used in combination with CBT or applied relaxation.
  • A medium- to long-term course of SSRIs is usually required of at least six months.
  • SSRIs aren't usually recommended for most pregnant women (particularly during the first three months of pregnancy) and breastfeeding women.
  • Side effects of SSRIs include feeling sick, low sex drive, blurred vision, diarrhoea or constipation, excessive sweating, and feeling agitated.
Pregabalin

Pregabalin can be used as an alternative to SSRIs if you're unable to take them for medical reasons or experience severe side effects. It works by altering the levels of certain brain chemicals.

  • Proven to be effective in reducing feelings of anxiety.
  • Not suitable for pregnant or breastfeeding women.
  • Side effects can include dizziness and drowsiness.
Benzodiazepines

A group of medications designed to promote calmness and relaxation.

  • Can be useful for treating a sudden flare-up of anxiety and panic.
  • Not suitable for long-term use as they can be addictive.