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The Pharmacologic Treatment of Anxiety Disorders: A Review of Progress
Abstract
Anxiety disorders, as a group, are among the most common mental health conditions and frequently cause significant functional impairment. Both psychotherapeutic and pharmacologic techniques are recognized to be effective management strategies. This review provides a discussion of the major classes of psychotropic medications investigated in clinical trials of the following anxiety disorders: panic disorder, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, and obsessive-compulsive disorder. Findings suggest that both selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are useful first-line agents for most of the anxiety disorders, particularly given the frequent comorbidity with mood disorders. Highly serotonergic agents are preferred for obsessive-compulsive disorder. Other antidepressants, such as tricyclic antidepressants or monoamine oxidase inhibitors, are generally reserved as second- and third-line strategies due to tolerability issues. Evidence for other agents, including anticonvulsants and atypical antipsychotics, suggests that they may have an adjunctive role to antidepressants in cases of treatment resistance, while azapirones have been used effectively for generalized anxiety disorder, and a substantial body of evidence supports benzodiazepine use in panic disorder and generalized anxiety disorder. Despite notable advances, many patients with anxiety disorders fail to adequately respond to existing pharmacologic treatments. Increased research attention should be focused on systematizing pharmacologic and combined pharmacologic-psychosocial strategies to address treatment resistance and developing novel treatments for anxiety disorders.
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“It is the most widely used pharmacological target for treating depression and anxiety (Belmaker and Agam, 2008; Ravindran and Stein, 2010)”
From Anatomically defined and functionally distinct dorsal raphe serotonin sub-systems (2018) · cites this paper as Ravindran and Stein, 2010
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Metadata
- Authors
- Ravindran, L. N., & Stein, M. B.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Stein, Murray B.
- ORCID
- Stein, Murray B.
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2010-06-11
- Volume
- 71
- Issue
- 07
- Pages
- 839-854
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2045726637
- Cited by
- 317
- References
- 0
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 13 · 2023: 17 · 2022: 17 · 2021: 17 · 2020: 13 · 2019: 24 · 2018: 25 · 2017: 14 · 2016: 26 · 2015: 25 · 2014: 26 · 2013: 21 · 2012: 25
- FWCI
- 33.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH-64122, K24MH064122)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- anxiety disorders, pharmacotherapy, panic disorder, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors, antiepileptic drugs, atypical antipsychotics, azapirones, benzodiazepines, treatment resistance
- MeSH terms
- Anticonvulsants, Antidepressive Agents, Anxiety Disorders, Benzodiazepines, Buspirone, Humans, Obsessive-Compulsive Disorder, Phobic Disorders, Psychotropic Drugs, Stress Disorders, Post-Traumatic, Antipsychotic Agents, Randomized Controlled Trials as Topic, Panic Disorder
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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