[Treatment of anxiety syndrome. A systematic literature review. Summary and conclusions by the SBU].
A report by the Swedish Council on Technology Assessment in Health Care (SBU) has reviewed, classified and evaluated the scientific literature on treatment of panic syndrome, specific phobias, social phobia, obsessive-compulsive syndrome (OCD), generalized anxiety syndrome (GAD) and post-traumatic stress disorder (PTSD). The review included treatment of children, adolescents and adults. The report concludes that there is effective treatment available for all anxiety syndromes. However in general, the effect is often moderate and symptoms reappear when the treatment period is discontinued. For adults, scientific evidence supports the use of paroxetine and sertraline for all syndromes except specific phobias. For the other SSRI's there is also evidence for the use of fluoxetin in OCD and PTSD, for fluvoxamine in social phobia and OCD and for escitalopram in social phobia. Other antidepressant drugs with a strong scientific support is venlafaxin in social phobia and GAD, imipramin in panic syndrome and chlomipramine in panic syndrome and OCD. Among psychological treatments, there is scientific evidence for cognitive behavior therapy (CBT) for treatment of panic syndrome, specific phobias, social phobia, PTSD and GAD. Exposure, with or without other psychotherapeutic interventions, has scientific support for efficacy in panic disorder (both in terms of number of panic attacks and for agoraphobia), specific phobias, OCD and PTSD. Use of eye movement desensitization and reprocessing (EMDR) has scientific support for treatment of PTSD.
von Knorring
Lars
L
Institutionen för neurovetenskap, psykiatri, Akademiska sjukhuset, Uppsala, Sweden. lars.von_knorring@uaspsyk.uu.se
Thelander
Sten
S
Pettersson
Agneta
A
D000293:Adolescent; D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D014151:Anti-Anxiety Agents; D018687:Antidepressive Agents, Second-Generation