Guidelines for the pharmacological treatment of anxiety disorders, obsessive–compulsive disorder and posttraumatic stress disorder in primary care

Abstract

Objective. Anxiety disorders are frequently under-diagnosed conditions in primary care, although they can be managed effectively by general practitioners. Methods. This paper is a short and practical summary of the World Federation of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety disorders, obsessive–compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) for the treatment in primary care. The recommendations were developed by a task force of 30 international experts in the field and are based on randomized controlled studies. Results. First-line pharmacological treatments for these disorders are selective serotonin reuptake inhibitors (for all disorders), serotonin-norepinephrine reuptake inhibitors (for some) and pregabalin (for generalized anxiety disorder only). A combination of medication and cognitive behavior/exposure therapy was shown to be a clinically desired treatment strategy. Conclusions. This short version of an evidence-based guideline may improve treatment of anxiety disorders, OCD, and PTSD in primary care.

Key Words::

• Anxiety disorders
• guidelines
• panic disorder
• generalized anxiety disorder
• social anxiety disorder
• pharmacological treatment

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Erratum

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Acknowledgements

None.

Statement of Interest

The development of these guidelines was not supported by any pharmaceutical company. Borwin Bandelow has received grants/research support, consulting fees and honoraria within the last 3 years from AstraZeneca, Bristol-Myers-Squibb, Glaxo-SmithKline, Jazz, Merck, Lilly, Lundbeck, Ono Pharma, Otsuka, Pfizer and Servier. Robertas Bunevicius has received grants/research support, consulting fees and honoraria within the last 3 years from Lundbeck, AstraZeneca, Teva. Eric Hollander has received grant/research support, consulting fees and honoraria within the last years from Abbott BMS, Janssen, Nastech, and Neuropharm. Joseph Zohar has received grants/research support, consulting fees and honoraria within the last 3 years from Glaxo-Smith Kline, Lundbeck, Pfizer, Servier, Teva and Wyeth. Siegfried Kasper received grants/research support, consulting fees and honoraria within the last three years from AstraZeneca, Bristol-Myers Squibb, CSC, Eli Lilly, GlaxoSmithKline, Janssen Pharmaceutica, Lundbeck, MSD, Novartis, Organon, Pierre Fabre, Pfizer, Schwabe, Sepracor, Servier, Wyeth. Hans-Jürgen Möller has received grant/research support, consulting fees and honoraria within the last years from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen Cilag, Lundbeck, MSD, Novartis, Organon, Otsuka, Pfizer, Schwabe, Sepracor, Servier, and Wyeth. Leo Sher: nothing to disclose.