Journal of Anxiety Disorders, bl. 9, No. 3, pp. 217-227.1995 C:opyrigtu 8 1995Else&r science Ltd Printedin the USA. All rights reserved 0887-6185/95 $9.50+ XXI 08874185(9s)oooO3-8 Effects of Alprazolam Dose on the Induction and Habituation Processes During Behavioral Panic Induction Treatment WILLIAM T. RILEY, MARK G. F. MCCORMICK, ERIN M. SIMON, KATHY STACK, YAACOV PUSHKIN, MARY M. OVERSTREET, JUANJ. CAR~~ONA, AND CYNTHIA MAGAK~AN Medical College of Virginia, Virginia Commonwealth University Abstract - To determine the effects of alprazolam dose levels on psychophysiolog- ic indices of panic induction and habituation during cognitive-behavioral treatment (CBT), 24 patients with panic disorder completed 15 sessions of CBT, and were ran- domly assigned to either a minimal or moderate. dose alprazolam condition. At pre- treatment, and at an early and late induction session, the magnitude and duration of physiologic changes (EMG, GSR, HR) were recorded during baseline relaxation, panic induction, and return to relaxation periods. Although dose conditions did not differ on the magnitude of physiologic change, patients in the moderate dosecondi- tion required significantly longer to obtain peak HR during panic induction and sig- nificantly less time to return to baseline HR than did the minimal dose condition. These physiologic differences, however, were not associated with treatment outcome. These results suggest that alprazolam may delay the process of panic induction during cognitive-behavioral treatment of panic disorder, but also appears to enhance the sub- sequent habituation process. Research on the treatment of panic disorder and agoraphobia has supported two major modalities: psychotropic medications and cognitive-behavioral therapy. Among the psychotropic medications, tricyclic antidepressants, MAOIs, and benzodiazepines have been found effective in the alleviation of panic attacks and concomitant agoraphobic avoidance (Ballenger, Burrows, DuPont, & Lesser, 1988; Sheehan, Ballenger, & Jacobsen, 1980). Similarly, cognitive-behavioral therapy involving components of relaxation, cognitive This study was supported in part by grants from the A. D. Williams Foundation and the Upjohn Phatmaceutical Company. Correspondence should be addressed to Wdliam T. Riley, Ph.D., wt of Psychiatry Medical cdege of Vbginia, Via Commonwealth University, Box 980253, Richmond, VA 23298. 217