Combining Exposure Therapy with Medications

Chapter 8 covers the impact of combined medication and exposure treatments. Any time two treatments coincide, there is a risk that patients may wonder what gains are associated with which treatment. Fortunately, the research supports that patients who are taking medications still benefit from exposure therapy. However, if medication is discontinued after therapy, there is a risk of relapse due to misattribution and withdrawal symptoms. This is particularly true for benzodiazepine medications. Ideally, patients will agree to either eliminate use of benzodiazepines before exposure begins or at least switch from an as needed basis to scheduled dosing regimen. If, however, the patient completes exposure in the context of a medication he or she intends to discontinue, the authors recommend several strategies to protect against relapse. Interoceptive exposure can be helpful in preparing for a medication taper by learning safety even during uncomfortable withdrawal sensations. In addition, the authors recommend a slow taper combined with exposure before, during, and after medication discontinuation.