Psychiatria pre prax 6/2005

PHARMACOTHERAPY AND PSYCHOTHERAPY OF ANXIETY DISORDERS

The anxiety disorders are the most common mental disorders, yet many of these patients are still not treated effectively. The goal of treatment is not only to alleviate symptoms but also management of co-morbidities, improvement of quality of life, decrease of overall vulnerability and elimination of relapses. In patients with symptoms of mild to moderate intensity the first choice of evidence-based treatments should be psychotherapy. Cognitive behavioral therapy has been proven in controlled clinical trials as highly effective option in both short-term and long-term treatment. The aim of the treatment should always be achievement of a full remission; otherwise there is an increased risk of relapse. Drugs used to treat anxiety disorders should be chosen based on generally accepted guidelines and their adverse reactions and limitations should always be considered from person to person. Antidepressants are preferred to benzodiazepines, with selective serotonin reuptake inhibitors (SSRIs) as the first choice.

Keywords: anxiety disorders, pharmacotherapy, cognitive behavioral therapy.