Anxiety Disorders: Drug Therapy

Therapy target

Improvement of the symptomatology

Therapy recommendations

* Benzodiazepines are approved for the acute treatment of tension, agitation, and anxiety.

Further notes

  • According to a meta-analysis, the effects of psychotherapeutic or drug treatment of anxiety disorder persist after 2 years. This refutes the hypothesis that patients with an anxiety disorder relapse rapidly after discontinuation of pharmacotherapy.
  • Caveat (Warning): hydroxyzine is contraindicated in patients with known or congenital (congenital) QT interval prolongation or with a known risk factor for QT time prolongation (eg. cardiovascular disease, family history of sudden cardiac death (PHT), electrolyte disturbances such as hypokalemia (potassium deficiency) or hypomagnesemia (magnesium deficiency), bradycardia (excessively slow heart rate: < 60 beats per minute), concomitant treatment with other drugs with known potential for QT time prolongation or for the occurrence of torsade de pointes). Patients with comedication (administration of other medications in addition to an already established medication) that may cause hypokalemia (potassium deficiency) and bradycardia (heartbeat too slow: < 60 beats per minute) should be treated with caution.

Phytotherapeutics

  • Lavender oil: after two weeks of therapy with lavender oil (80 mg/day), there was significant anxiety relief; after six weeks, the antianxiety effect and improvement in quality of life were equivalent to that of lorazepam (drug from the benzodiazepine group; 0.5 mg/day)

Supplements (dietary supplements; vital substances)

Suitable dietary supplements should contain the following micronutrients (vital substances):

  • Vitamins (pyridoxine (vitamin B6))
  • Minerals (magnesium)
  • Other vital substances (ashwagandha (sleeping berry))

In the presence of insomnia (sleep disorders) as a result of the anxiety disorder, see below Insomnia/Medicinal Therapy/Supplements.

Note: The listed vital substances are not a substitute for drug therapy. Food supplements are intended to supplement the general diet in the respective life situation.

Guidelines

  1. S3 guideline: treatment of anxiety disorders. (AWMF Register Number: 051-028), April 2014 Abstract Long version.