title: [Treatment-resistant anxiety disorders: social phobia, generalized anxiety disorder and panic disorder].
abstract: OBJECTIVE
  Anxiety disorders are common psychiatric conditions that cause significant disability, poor quality of life and enormous social cost. Although treatments with demonstrable efficacy are available a great number of patients fail to respond or remains with clinically significant residual symptoms after treatment. The objective of this study is to review aspects related to treatment resistance and pharmacological strategies to deal with anxiety disorders resistant to treatment.
  
  
  METHODS
  Narrative review.
  
  
  RESULTS
  We discuss conceptual aspects related to treatment resistance or refractoriness, predictors of poor treatment outcome, and finally, some strategies to deal with anxiety disorders (including social anxiety disorder, generalized anxiety disorder and panic disorder) that do not respond to standard therapeutic interventions.
  
  
  CONCLUSIONS
  Treatment resistance in anxiety disorders remains a challenge to clinical practice going from non standardized concepts of response and resistance to a paucity of controlled studies concerning therapeutic strategies.
authors.affiliation: Programa de Ansiedade e Depressão, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. menezesg@globo.com
authors.forename: Gabriela Bezerra de
authors.initials: GB
authors.lastname: Menezes
authors.forename: Leonardo F
authors.initials: LF
authors.lastname: Fontenelle
authors.forename: Sara
authors.initials: S
authors.lastname: Mululo
authors.forename: Márcio
authors.initials: M
authors.lastname: Versiani
mesh_terms: D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000188:drug therapy; D004351:Drug Resistance; D006801:Humans; D016584:Panic Disorder / Q000188:drug therapy; D010698:Phobic Disorders / Q000188:drug therapy
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents
vernacular_title: Resistência ao tratamento nos transtornos de ansiedade: fobia social, transtorno de ansiedade generalizada e transtorno do pânico.