David Baxter PhD
Late Founder
Medication Dosing in Anxiety Disorders: What the Evidence Shows
by Dr. M.P. White
Primary Psychiatry. 2009;16(10):21-28
Dr White is clinical instructor of Psychiatry and Behavioral Science-Behavioral Medicine and postdoctoral medical fellow of Psychiatry and Behavioral Science at Stanford University in California.
Social anxiety disorder, generalized anxiety disorder, and panic disorder are common and sometimes disabling conditions. While benzodiazepines, antidepressants, buspirone, and several anticonvulsants are frequently used to treat these conditions, an individual medication is often used as a member of "class" without specific attention to the data behind its use in a particular condition.
This article reviews the state of the literature regarding the most common medications used to treat these anxiety disorders with specific attention to optimal dosing. For most of these medications there is sufficient data to suggest a minimum and average effective dose. More problematic, however-and with instructive data for only a few medications-is the question as to whether dosages higher than these levels can provide increased likelihood or degree of response.
Source + Full Text
by Dr. M.P. White
Primary Psychiatry. 2009;16(10):21-28
Dr White is clinical instructor of Psychiatry and Behavioral Science-Behavioral Medicine and postdoctoral medical fellow of Psychiatry and Behavioral Science at Stanford University in California.
- Despite their common use, benzodiazepine dosing in anxiety disorders remains poorly studied.
- Several selective serotonin reuptake inhibitors (SSRIs), including fluoxetine, citalopram, and escitalopram, have limited data regarding use in anxiety disorders
- There may be diminishing returns for higher doses of SSRIs and serotonin norepinephrine reuptake inhibitors (SNRIs).
- SNRIs, particularly extended release venlafaxine, may be useful at lower doses.
- Buspirone, gabapentin, and pregabalin have limited supporting data in anxiety; of these, pregabalin is by far the best characterized.
Social anxiety disorder, generalized anxiety disorder, and panic disorder are common and sometimes disabling conditions. While benzodiazepines, antidepressants, buspirone, and several anticonvulsants are frequently used to treat these conditions, an individual medication is often used as a member of "class" without specific attention to the data behind its use in a particular condition.
This article reviews the state of the literature regarding the most common medications used to treat these anxiety disorders with specific attention to optimal dosing. For most of these medications there is sufficient data to suggest a minimum and average effective dose. More problematic, however-and with instructive data for only a few medications-is the question as to whether dosages higher than these levels can provide increased likelihood or degree of response.
Source + Full Text