Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany.
Adv Exp Med Biol. 2020;1191:347-365. doi: 10.1007/978-981-32-9705-0_19.
Anxiety disorders, including panic disorder/agoraphobia (PDA), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and others, are the most prevalent mental disorders. In this paper, recommendations are given for the psychopharmacological treatment of these disorders which are based on comprehensive treatment guidelines, meta-analyses, and systematic reviews of available randomized controlled studies. Anxiety disorders can effectively be treated with psychotherapy, pharmacotherapy, or a combination of both. First-line drugs are the selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Benzodiazepines are not recommended for routine use due to their possible addiction potential. Other treatment options include the calcium modulator pregabalin, tricyclic antidepressants, buspirone, moclobemide, and others. Drug treatment can be combined with psychological treatments. Novel treatment strategies include medications that act on GABA, glutamate, and other neurotransmitter systems. After remission, medications should be continued for 6 to 12 months.
焦虑障碍，包括惊恐障碍/广场恐怖症（PDA）、广泛性焦虑障碍（GAD）、社交焦虑障碍（SAD）等，是最常见的精神障碍。本文根据综合治疗指南、荟萃分析和现有随机对照研究的系统评价，为这些障碍的精神药理学治疗提供了建议。焦虑障碍可以通过心理治疗、药物治疗或两者结合有效地治疗。一线药物是选择性 5-羟色胺再摄取抑制剂（SSRIs）和 5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRIs）。由于可能存在成瘾潜力，不建议常规使用苯二氮䓬类药物。其他治疗选择包括钙调节剂普瑞巴林、三环类抗抑郁药、丁螺环酮、吗氯贝胺等。药物治疗可以与心理治疗相结合。新的治疗策略包括作用于 GABA、谷氨酸和其他神经递质系统的药物。缓解后，应继续服用药物 6 至 12 个月。
