Drug treatment for anxiety

Abstract

Antidepressants are recommended as firstline when pharmacotherapy is required for anxiety disorders. Selective serotonin reuptake inhibitors are effective in all anxiety disorders, and selective and noradrenaline reuptake inhibitors in most anxiety disorders. They are the drugs of first choice. With the exception of obsessive compulsive disorder, there is little evidence of a dose- response relationship with antidepressants and many patients will respond to standard doses. Anxiety is generally slower to respond to treatment than depression and clinicians should avoid rapid dose escalation. The outcomes are likely to be enhanced if patients receive cognitive behavioural therapy in addition to pharmacotherapy. Benzodiazepines are not the first-line treatment for anxiety disorders.