OBJECTIVE: To gain insight into the experience and practice of psychiatrists in the pharmacological management of patients with generalized anxiety disorder (GAD). METHODS: Multiple-choice questionnaire completed by 501 psychiatrists (representing a 45% response rate) from 18 countries, selected by pharmaceutical company representatives to attend a scientific meeting, through having an interest in anxiety disorders. RESULTS: Use of screening tools, routine structured diagnostic interviews, and practice guidelines was infrequent. Over one-third of patients did not receive their initial psychiatric consultation within a month after referral. A total of 45% of patients had symptoms for 2 years or longer before being diagnosed and treated. Most patients had been treated with benzodiazepines before referral. 80% of respondents always or often prescribed selective serotonin reuptake inhibitors (SSRIs), 43% serotonin-norepinephrine reuptake inhibitors (SNRIs), or pregabalin (35%) as first-line treatments. The most frequently recommended second-line treatments were SNRIs (41%) and pregabalin (36%). Concentration difficulties, fatigue, excessive worrying and pain were reported as the symptoms most difficult to manage. CONCLUSIONS: Patients with GAD have frequently been treated with benzodiazepines before referral to a psychiatrist. SSRIs were the preferred first-line treatment, and SNRIs and pregabalin preferred second-line treatments. Reported practice in this sample appears largely consistent with recent evidence-based treatment guidelines.
OBJECTIVE: To gain insight into the experience and practice of psychiatrists in the pharmacological management of patients with generalized anxiety disorder (GAD). METHODS: Multiple-choice questionnaire completed by 501 psychiatrists (representing a 45% response rate) from 18 countries, selected by pharmaceutical company representatives to attend a scientific meeting, through having an interest in anxiety disorders. RESULTS: Use of screening tools, routine structured diagnostic interviews, and practice guidelines was infrequent. Over one-third of patients did not receive their initial psychiatric consultation within a month after referral. A total of 45% of patients had symptoms for 2 years or longer before being diagnosed and treated. Most patients had been treated with benzodiazepines before referral. 80% of respondents always or often prescribed selective serotonin reuptake inhibitors (SSRIs), 43% serotonin-norepinephrine reuptake inhibitors (SNRIs), or pregabalin (35%) as first-line treatments. The most frequently recommended second-line treatments were SNRIs (41%) and pregabalin (36%). Concentration difficulties, fatigue, excessive worrying and pain were reported as the symptoms most difficult to manage. CONCLUSIONS:Patients with GAD have frequently been treated with benzodiazepines before referral to a psychiatrist. SSRIs were the preferred first-line treatment, and SNRIs and pregabalin preferred second-line treatments. Reported practice in this sample appears largely consistent with recent evidence-based treatment guidelines.
Authors: Martin A Katzman; Pierre Bleau; Pierre Blier; Pratap Chokka; Kevin Kjernisted; Michael Van Ameringen; Martin M Antony; Stéphane Bouchard; Alain Brunet; Martine Flament; Sophie Grigoriadis; Sandra Mendlowitz; Kieron O'Connor; Kiran Rabheru; Peggy M A Richter; Melisa Robichaud; John R Walker Journal: BMC Psychiatry Date: 2014-07-02 Impact factor: 3.630
Authors: Inmaculada Failde; Maria Dueñas; Luis Agüera-Ortíz; Jorge A Cervilla; Ana Gonzalez-Pinto; Juan A Mico Journal: BMC Psychiatry Date: 2013-04-15 Impact factor: 3.630