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Treatment strategies of obsessive-compulsive disorder and panic disorder/agoraphobia.

Abstract

Anxiety disorders represent the most prevalent psychiatric disorders. In addition, a considerable burden is associated with them, not only for individual sufferers, but also for the health care system. However, many patients who might benefit from treatment are not diagnosed or treated. This may partly be due to lack of awareness of the anxiety disorders by primary care practitioners and by the sufferers themselves. In addition, the stigma still associated with psychiatric disorders and lack of confidence in psychiatric treatments are factors leading to no/under recognition and treatment, or the use of unnecessary or inappropriate treatments. This paper aims to provide a comprehensive review of recommendations for the pharmacological treatment of two common anxiety disorders, in particular obsessive-compulsive disorder (OCD) and panic disorder (PD). The first-line treatments of OCD include medium-high doses of selective serotonin reuptake inhibitors (SSRIs) and clomipramine, a tricyclic (TCA) antidepressant with prevalent serotonergic activity. The recommended drugs for PD include SSRIs, TCAs and serotonin-norepinephrine reuptake inhibitors (SNRIs); in treatment-resistant cases, benzodiazepines like alprazolam may be used in patients with no history of addiction and tolerance. Other treatment options include irreversible and reversible monoamine-oxidase inhibitors, hydroxyzine, and others. Besides pharmacological treatments, some psychological strategies have been shown to be effective, in particular, cognitive behavior therapy (CBT) and other variants of behavior therapy that have been sufficiently investigated in controlled studies, and, therefore, will be reviewed herein.

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  • Authors

    Marazziti D, Carlini M, Dell'Osso L

    Institution

    Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Italy. dmarazzi@psico.med.unipi.it

    Source

    Current topics in medicinal chemistry 12:4 2012 pg 238-53

    MeSH

    Agoraphobia
    Alprazolam
    Anti-Anxiety Agents
    Antidepressive Agents, Tricyclic
    Clomipramine
    Cognitive Therapy
    Histamine H1 Antagonists
    Humans
    Hydroxyzine
    Monoamine Oxidase Inhibitors
    Obsessive-Compulsive Disorder
    Panic Disorder
    Psychotherapy
    Serotonin Uptake Inhibitors

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22204483