International study of expert judgement on therapeutic use of benzodiazepines and other psychotherapeutic medications: II. Pharmacotherapy of anxiety disorders.
OBJECTIVE
To assemble expert clinical experience and judgement in the treatment of anxiety and related disorders in a systematic, quantitative manner.


METHODS
A panel of internationally recognized Experts in treating anxiety and depression was constituted by multistage peer nomination. 90% completed a questionnaire. This report focuses on case vignettes of 7 anxiety disorders followed by questions about relevant therapeutic options.


RESULTS
Panelists usually recommended both psychological and pharmacological interventions. Most favored antidepressants, usually tricyclic, for agoraphobia, panic and OCD; beta-blockers for specific social phobia; and benzodiazepines for GAD and adjustment disorder. Some Experts favored polypharmacy, usually an antidepressant and a benzodiazepine. The majority usually advocated pharmacotherapy for 6 months or more. They recommended the same duration of treatment with benzodiazepines and other medications, except for GAD.


CONCLUSIONS
The responses of the Expert Panel imply that; (1) most anxiety disorders are serious and merit vigorous, prolonged pharmacotherapy; and (2) antidepressants and benzodiazepines are effective and safe for long-term treatment of these conditions. This outcome contrasts with the widespread apprehension about long-term pharmacotherapy, especially with benzodiazepines, and some regulatory views.
Uhlenhuth
E H
EH
Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque 87131, USA.
Balter
M B
MB
Ban
T A
TA
Yang
K
K
D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000523:psychology; D001569:Benzodiazepines; D003431:Cross-Cultural Comparison; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006801:Humans; D016584:Panic Disorder / Q000188:drug therapy / Q000523:psychology; D010348:Patient Care Team; D010698:Phobic Disorders / Q000188:drug therapy / Q000523:psychology; D011358:Product Surveillance, Postmarketing
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D001569:Benzodiazepines