Pharmacologic treatment of anxiety disorders in 1989 versus 1996: Results from the Harvard/Brown anxiety disorders research program

Objective: This article reports on the pharmacologic treatment of patients diagnosed with generalized anxiety disorder (GAD) enrolled in a naturalisti c long-term study of anxiety disorders, with enrollment in 1989 through 199 1 and follow-up in 1996. Method: 711 patients were enrolled in the study during 1989-1991, At intake , 167 patients met DSM-III-R criteria for GAD; at 1996 followup, 103 patien ts met these criteria. The patients were divided into 3 groups by diagnosis : GAD alone (N = 18 at intake, N = ii at follow-up), GAD comorbid with anot her anxiety disorder (N = 84 at intake, N = 52 at follow-up), and GAD comor bid with Research Diagnostic Criteria-defined major depressive disorder, wi th or without another anxiety disorder (N = 65 at intake, N = 40 at follow- up). The groups were evaluated at intake and follow-up on whether they rece ived medication and the types of medication they received. Results: Nearly one third of patients in the 1989-1991 sample were not rece iving any medication for treatment of their anxiety disorder; in 1996, 27% of patients still were receiving no medication. There was a decrease in ben zodiazepine treatment and an increase in antidepressant treatment in 1996 f or GAD patients who did not have comorbid depression or another anxiety dis order. Conclusion: The finding of one quarter to one third of patients with GAD re ceiving no medication is consistent with previous observations of undertrea tment of depression. The findings on medication type suggest a shift in the type of medications being prescribed for treatment of GAD from exclusive b enzodiazepine treatment to the combination of benzodiazepine and antidepres sant treatment.