Anxiolytics

2018 ◽  
Author(s):  
Shadi Doroudgar ◽  
Gurjit Bains
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Alternative Therapy ◽  
Term Therapy ◽  
Key Points ◽  
Long Term Therapy ◽  
Pharmacologic Agents ◽  
Underlying Pathophysiology

The underlying pathophysiology of anxiety disorders revolve around neurotransmitter transmission, the pharmacologic target of common medication treatments. Pharmacologic treatment of anxiety disorders generally consists of benzodiazepines for short-term relief of anxiety symptoms and antidepressants as a long-term therapy. Benzodiazepines use should be limited because of habit-forming properties, dependence, and risk of adverse effects. Antidepressants are the typically preferred initial agents for long-term use due to efficacy and lack of dependence. Anxiety disorders may occur as comorbidities with other psychiatric disorders. Other pharmacologic agents are utilized as alternative therapy for patients who do not respond to mainstay therapy or are not candidates for the treatment with antidepressants. This review contains 1 figure, 6 table and 77 references Key Points: anxiety disorders, benzodiazepines, generalized anxiety disorder, norepinephrine, panic disorder, social anxiety disorder, selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors

WCA Recommendations for the Long-Term Treatment of Social Phobia

CNS Spectrums ◽  
2003 ◽  
Vol 8 (S1) ◽  
pp. 40-52 ◽  
Author(s):  
Michael Van Ameringen ◽  
Christer Allgulander ◽  
Borwin Bandelow ◽  
John H. Greist ◽  
Eric Hollander ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Phobia ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Randomized Clinical Trials ◽  
Behavioral Therapy ◽  
Social Performance ◽  
Term Treatment ◽  
Term Therapy ◽  
Long Term Treatment

ABSTRACTWhat is the best approach for treating patients with social phobia (social anxiety disorder) over the long term? Social phobia is the most common anxiety disorder, with reported prevalence rates of up to 18.7%. Social phobia is characterized by a marked and persistent fear of being observed or evaluated by others in social performance or interaction situations and is associated with physical, cognitive, and behavioral (ie, avoidance) symptoms. The onset of social phobia typically occurs in childhood or adolescence and the clinical course, if left untreated, is usually chronic, unremitting, and associated with significant functional impairment. Social phobia exhibits a high degree of comorbidity with other psychiatric disorders, including mood disorders, anxiety disorders, and substance abuse/dependence. Few people with social phobia seek professional help despite the existence of beneficial treatment approaches. The efficacy, tolerability, and safety of the selective serotonin reuptake inhibitors (SSRIs), evidenced in randomized clinical trials, support these agents as first-line treatment. The benzodiazepine clonazepam and certain monoamine oxidase inhibitors (representing both reversible and nonreversible inhibitors) may also be of benefit. Treatment of social phobia may need to be continued for several months to consolidate response and achieve full remission. The SSRIs have shown benefit in longterm treatment trials, while long-term treatment data from clinical studies of clonazepam are limited but support the drug's efficacy. There is also evidence for the effectiveness of exposure-based strategies of cognitive-behavioral therapy, and controlled studies suggest that the effects of treatment are generally maintained at long-term follow-up. In light of the chronicity and disability associated with social phobia, as well as the high relapse rate after short-term therapy, it is recommended that effective treatment be continued for at least 12 months.

Prediction of Demographic Factors on the Outcome of Short- and Long-term Psychotherapy

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
K. Joutsenniemi ◽  
O. Lindfors ◽  
M. Laaksonen ◽  
P. Haaramo ◽  
P. Knekt
Keyword(s):  
Anxiety Disorders ◽  
Psychodynamic Psychotherapy ◽  
Psychiatric Symptoms ◽  
Demographic Factors ◽  
Term Therapy ◽  
Short Term ◽  
Short And Long Term ◽  
Long Term Therapy

Background:Demographic factors have been shown to predict the outcome of short-term psychotherapy in the treatment of depressive and anxiety disorders. So far, however, information on the prediction for long- term therapy is missing. to be able to choose an optimal psychotherapy length for the patient, it is essential to know, which demographic factors predict different outcome in short- and long-term therapy.Aim:To compare the prediction of demographic factors on changes in psychiatric symptoms in short- and long-term psychotherapy.Methods:In the Helsinki Psychotherapy Study, 326 psychiatric outpatients, aged 20-46 years, and suffering from depressive or anxiety disorders, were randomly assigned to short-term therapy (short-term psychodynamic psychotherapy or solution-focused therapy combined) or long-term psychodynamic psychotherapy. the demographic factors (i.e. age, gender, education, income, and living arrangement) were assessed at baseline by a questionnaire. Psychiatric symptoms were assessed with the Symptom Check List, Global Severity Index (SCL-90-GSI) at baseline and 7 times during a 3-year follow-up.Results:Demographic factors were found to predict symptom development during follow-up irrespective of baseline symptom level. Female gender, being aged 25 or more, living with a spouse/partner, high education, and medium level personal income predicted benefiting sufficiently from short-term therapy, whereas being aged under 25, medium education, and living with other(s) than a partner or child(ren) predicted the need of long-term therapy.Conclusions:Demographic factors may be a useful tool in the selection of patients for short- and long term therapy.

Antithrombotic Therapy for DVT/PE

1997 ◽  
Vol 17 (03) ◽  
pp. 161-162
Author(s):  
Thomas Hyers
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Oral Anticoagulants ◽  
Cost Effective ◽  
Therapeutic Agents ◽  
Great Promise ◽  
Term Therapy ◽  
Low Molecular Weight ◽  
Long Term Therapy

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.

Office-based post-marketing surveillance study on the influence of long term therapy with aripiprazole in patients with schizophrenia

2007 ◽  
Vol 40 (05) ◽  
Author(s):  
M Kungel ◽  
A Engelhardt ◽  
T Spevakné-Göröcs ◽  
M Ebrecht ◽  
C Werner ◽  
...  
Keyword(s):  
Surveillance Study ◽  
Term Therapy ◽  
Post Marketing Surveillance ◽  
Post Marketing ◽  
Long Term Therapy
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