Selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological treatment for panic disorder based on their low rate of side effects, lack of dietary restrictions, and absence of tolerance. SSRIs and venlafaxine are attractive first-line treatments for social anxiety disorder. Pharmacological treatments of choice for generalized anxiety disorder are buspirone and antidepressants, including SSRIs and venlafaxine. Benzodiazepines, although effective for all these disorders, lack efficacy for comorbid depression and carry the risk of physiological dependence and withdrawal symptoms. Their greatest utility seems to be as an initial or adjunctive medication for patients with disabling symptoms requiring rapid relief and for those unable to tolerate other medications. Chronic treatment with benzodiazepines is generally safe and effective but should probably be reserved for patients nonresponsive or intolerant to other agents. Larger trials are necessary to determine whether pharmacological agents might be useful as monotherapies, or adjuncts to exposure psychotherapy, for specific phobia.
Functional Neuroimaging of Anxiety: A Meta-Analysis of Emotional Processing in PTSD, Social Anxiety Disorder, and Specific Phobia
