title: Review of atypical antipsychotics in anxiety.
abstract: Atypical antipsychotics are increasingly used for treatment of anxiety disorders, either in mono- or combination therapy. This is the first review reporting on the use of atypical antipsychotics in monotherapy or augmentation in patients with primary anxiety disorders or anxiety (disorders) comorbid to schizophrenia, bipolar disorder (BPD) and major depressive disorder (MDD). We included 49 open-label trials, 32 randomized, placebo-controlled trials (RCTpls) and five randomized controlled trials without placebo arm with almost 6000 patients (open-label: 1710, randomized: 4145). An increasing number of RCTpls show promising results in 27-71% of patients with primary or comorbid anxiety disorders who were treated with monotherapy atypical antipsychotics or augmentation therapy. However, methodological flaws of included studies may limit conclusions of this review and larger placebo-controlled trials are warranted comparing standard treatment with monotherapy and augmentation therapy of atypical antipsychotics and placebo. In addition, higher dropout rates and side effects from treatment with atypical antipsychotics may limit the use of atypical antipsychotics in patients with anxiety disorders.
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands. n.c.vulink@amc.nl
authors.forename: Nienke C C
authors.initials: NC
authors.lastname: Vulink
authors.forename: Martijn
authors.initials: M
authors.lastname: Figee
authors.forename: Damiaan
authors.initials: D
authors.lastname: Denys
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000453:epidemiology; D015897:Comorbidity; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic; D012107:Research Design
chemical_list: D014150:Antipsychotic Agents