Treatment of anxiety disorders

作者：Borwin Bandelow, Sophie Michaelis, Dirk Wedekind · 发表于：Dialogues in Clinical Neuroscience · 年份：2017 · DOI：10.31887/dcns.2017.19.2/bbandelow · 被引用次数：803 · 研究领域：Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes、Child and Adolescent Psychosocial and Emotional Development、Mental Health Treatment and Access

Anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, social anxiety disorder, and others) are the most prevalent psychiatric disorders, and are associated with a high burden of illness. Anxiety disorders are often underrecognized and undertreated in primary care. Treatment is indicated when a patient shows marked distress or suffers from complications resulting from the disorder. The treatment recommendations given in this article are based on guidelines, meta-analyses, and systematic reviews of randomized controlled studies. Anxiety disorders should be treated with psychological therapy, pharmacotherapy, or a combination of both. Cognitive behavioral therapy can be regarded as the psychotherapy with the highest level of evidence. First-line drugs are the selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Benzodiazepines are not recommended for routine use. Other treatment options include pregabalin, tricyclic antidepressants, buspirone, moclobemide, and others. After remission, medications should be continued for 6 to 12 months. When developing a treatment plan, efficacy, adverse effects, interactions, costs, and the preference of the patient should be considered.