Medical Management of Co-Morbid Anxiety and Substance Use Disorder

Abstract

This chapter will focus on the pharmacological treatments that have been used to treat anxiety in individuals with SUDs. These treatments include a number of drug classes such as benzodiazepines, tricyclic antidepressants (TCAs) and related drugs, monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs), buspirone, dopamine D2 antagonists, anticonvulsants, and beta-blockers. The selection of a particular drug class, and of a specific drug within that class, should be determined by the evidence base supporting its use and by whether the patient has had any experience of treatment with that compound (Baldwin et al., 2005). Treating doctors must be aware of the major adverse effects and problems associated with the prescription of these psychotropic drugs. The chapter opens with a section on general guidelines for treatment. The above drugs will then be discussed in the context of anxiety and a range of SUDs including alcohol, opioid, stimulant, cannabis, and benzodiazepine use disorders. Finally the pharmacological treatment options for the specific anxiety disorders that commonly co-exist with SUDs will be considered. (PsycINFO Database Record (c) 2019 APA, all rights reserved) (Source: chapter)