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Antidepressant]]s
Antidepressant]]s
[[Benzodiazepines]] (some concern over dependency), [[buspirone]] [[tricyclic antidepressant]]s ,[[SSRI]]s ([[selective serotonin reuptake inhibitors]])
[[Benzodiazepines]] (some concern over dependency), [[buspirone]], [[tricyclic antidepressant]]s ,[[SSRI]]s ([[selective serotonin reuptake inhibitors]])


==Medical Therapy==
==Medical Therapy==

Revision as of 22:10, 22 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

The mainstay of therapy for anxiety is the administration of pharmacotherapy and psychotherapy

Antidepressant]]s Benzodiazepines (some concern over dependency), buspirone, tricyclic antidepressants ,SSRIs (selective serotonin reuptake inhibitors)

Medical Therapy

Pharmacotherapy

Evidence summary from NICE of selected medications[1]
  Evidence base Relative risk of
non-response
Relative risk of
Drug toxicity
Sertraline Trials: 2
(706 patients)
0.70* 1.1
Nausea
Sexual
Venlafaxine Trials: 12
(3470 patients)
0.80* 2.06*
Nausea
Sexual
Insomnia
Citalopram Trials: 1
(34 patients)
0.46* 3.0
Escitalopram Trials: 6
(2136 patients)
0.78 1.72*
Nausea
Sexual
Paroxetine Trials: 8
(2748 patients)
0.91 2.5*
Nausea
Sexual
Insomnia
Pregabalin Trials: 8
(2079 patients)
0.79* 1.3
Dizziness
Fatigue
Buspirone Trials: 5
(806 patients)
0.87 2.0*
Nausea
Dizziness
Hydroxyzine Trials: 3
(482 patients)
0.81 1.48
Little short term toxicity
Alprazolam Trials: 4
(544 patients)
0.87 1.3
Little short term toxicity
* P< 0.05

Psychotherapy

  • CBT is a type of psychotherapy that can help people with anxiety disorders. It teaches a person different ways of thinking, behaving, and reacting to anxiety-producing and fearful situations. CBT can also help people learn and practice social skills, which is vital for treating social anxiety disorder.
  • Two specific stand-alone components of CBT used to treat social anxiety disorder are cognitive therapy and exposure therapy. Cognitive therapy focuses on identifying, challenging, and then neutralizing unhelpful thoughts underlying anxiety disorders.
  • Exposure therapy focuses on confronting the fears underlying an anxiety disorder in order to help people engage in activities they have been avoiding. Exposure therapy is used along with relaxation exercises and/or imagery. One study, called a meta-analysis because it pulls together all of the previous studies and calculates the statistical magnitude of the combined effects, found that cognitive therapy was superior to exposure therapy for treating social anxiety disorder.
  • CBT may be conducted individually or with a group of people who have similar problems. Group therapy is particularly effective for social anxiety disorder. Often “homework” is assigned for participants to complete between sessions.[2]

References

  1. National Institute for Health and Clinical Excellence (2011). Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults
  2. Kivity Y, Huppert JD (2016). "Does cognitive reappraisal reduce anxiety? A daily diary study of a micro-intervention with individuals with high social anxiety". J Consult Clin Psychol. 84 (3): 269–83. doi:10.1037/ccp0000075. PMID 26795939.

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