INTERNATIONAL STUDY OF EXPERT JUDGMENT ON THERAPEUTIC USE OF BENZODIAZEPINES AND OTHER PSYCHOTHERAPEUTIC MEDICATIONS .2. PHARMACOTHERAPY OFANXIETY DISORDERS

Objective. To assemble expert clinical experience and judgement in the treatment of anxiety and related disorders in a systematic, quantitat ive manner. Methods: A panel of internationally recognized Experts in treating anxiety and depression was constituted by multistage peer nom ination. 90% completed a questionnaire. This report focuses on case vi gnettes of 7 anxiety disorders followed by questions about relevant th erapeutic options. Results: Panelists usually recommended both psychol ogical and pharmacological interventions. Most favored antidepressants , usually tricyclic, for agoraphobia, panic and OCD; beta-blockers for specific social phobia; and benzodiazepines for GAD and adjustment di sorder. Some Experts favored polypharmacy, usually an antidepressant a nd a benzodiazepine. The majority usually advocated pharmacotherapy fo r 6 months or more. They recommended the same duration of treatment wi th benzodiazepines and other medications, except for GAD. Conclusions: The responses of the Expert Panel imply that: (1) most anxiety disord ers are serious and merit vigorous, prolonged pharmacotherapy; and (2) antidepressants and benzodiazepines are effective and safe for long-t erm treatment of these conditions. This outcome contrasts with the wid espread apprehension about long-term pharmacotherapy, especially with benzodiazepines, and some regulatory views.