Anxiety disorders: a review of tricyclic antidepressants and selective serotonin reuptake inhibitors.
OBJECTIVE
Anxiety disorders are the most common mental health disorders. While the older tricylic antidepressants (TCAs) are efficacious in the treatment of many anxiety disorders, recent studies with fluoxetine and other selective serotonin reuptake inhibitors (SSRIs) have emphasized the role of serotonin in the aetiology of these conditions.


METHODS
We reviewed the efficacy, safety and tolerability of TCAs and SSRIs in the treatment of the most common anxiety disorders, specifically, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, social phobia and generalized anxiety disorder.


RESULTS
Both the TCA and SSRI antidepressants are effective in treating a wide variety of anxiety disorders. SSRIs, due to their greater safety and tolerability, should be the preferred choices in treating anxiety disorders in those instances where TCAs and SSRIs are considered equally effective. In the cases of OCD and social phobia, SSRIs are almost always preferable given that the TCAs do not appear effective in these disorders.


CONCLUSIONS
Further research is needed on the naturalistic long-term use of the TCAs and SSRIs in the treatment of anxiety disorders.
Zohar
J
J
Tel-Aviv University, Herzlia, Israel.
Westenberg
H G
HG
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy*; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy; D010698:Phobic Disorders / Q000188:drug therapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy; D016896:Treatment Outcome
D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors