Long-term outcome of anxiety disorders: a review of double-blind studies.
OBJECTIVE
Although anxiety disorders are acknowledged as chronic, the issue of the pharmacological treatment duration remains unsettled. This review focuses on the long-term outcome of patients with anxiety disorders as demonstrated by randomized controlled trials.


RESULTS
Results from long-term randomized controlled trials of antidepressants in anxiety disorders indicate that maintenance treatment significantly reduces the odds of relapse, whatever the anxiety disorder is. This result appears to be similar to what is reported in long-term studies in depressive disorders. In addition, regarding the natural course of depressive disorders, acknowledged as mostly recurrent, some patients may require very long-term treatment, that is, more than 2 years. Moreover, naturalistic studies in anxiety disorders indicate that the relapse risk after discontinuation is not associated with the treatment duration. Finally, there is no predictor to identify those patients who require long-term pharmacotherapy for anxiety disorders.


CONCLUSIONS
In light of this review, other long-term studies in anxiety disorders have to be undertaken to identify predictors of relapse after treatment discontinuation. As it is now acknowledged for depressive disorders, some patients may require very long-term pharmacological treatment for anxiety disorders.
Thuile
Jacques
J
Clinique des Maladies Mentales et de l'Encéphale, Centre Hospitalier Sainte-Anne, Université Paris V René Descartes, Paris, France. j.thuile@ch-sainte-anne.fr
Even
Christian
C
Rouillon
Frédéric
F
D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy*; D004311:Double-Blind Method; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents