30 - The treatment of anxiety disorders in primary care

Summary

This chapter reviews the treatment of anxiety disorders in primary care. Topics explored include medication effectiveness (e.g. sertraline, venlafaxine, pregabalin, herbal medication) and use of psychosocial interventions (e.g. cognitive-behavioral therapy, lifestyle modification therapy). At present, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are considered the first-line pharmacological treatment for anxiety disorders. General care was limited to a discussion of clinical history, psychoeducation on social anxiety disorder (SAD), and provision of general support by the primary care physician (PCP). Several alternatives to usual care have been explored in the treatment of mental disorders in primary care, including strategies that seek to overcome patient, physician, and process-of-care barriers. A systematic review of the efficacy of self-help manuals for anxiety disorders in primary care identified six studies. The development of interventions involving the participation of these and other types of health professionals should also be the focus of research.