Guidelines for the pharmacological treatment of anxiety disorders, obsessive–compulsive disorder and posttraumatic stress disorder in primary care

TLDR

Anxiety disorders are frequently under‑diagnosed in primary care, yet general practitioners can manage them effectively. This paper provides a concise summary of the World Federation of Biological Psychiatry guidelines for pharmacological treatment of anxiety disorders, OCD, and PTSD in primary care. The recommendations were formulated by a 30‑member international task force based on randomized controlled trials. First‑line treatments include SSRIs for all disorders, SNRIs for some, and pregabalin for generalized anxiety disorder, and the guideline endorses combining medication with cognitive‑behavioral or exposure therapy to improve care in primary settings.

Abstract

Objective. Anxiety disorders are frequently under-diagnosed conditions in primary care, although they can be managed effectively by general practitioners. Methods. This paper is a short and practical summary of the World Federation of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety disorders, obsessive–compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) for the treatment in primary care. The recommendations were developed by a task force of 30 international experts in the field and are based on randomized controlled studies. Results. First-line pharmacological treatments for these disorders are selective serotonin reuptake inhibitors (for all disorders), serotonin-norepinephrine reuptake inhibitors (for some) and pregabalin (for generalized anxiety disorder only). A combination of medication and cognitive behavior/exposure therapy was shown to be a clinically desired treatment strategy. Conclusions. This short version of an evidence-based guideline may improve treatment of anxiety disorders, OCD, and PTSD in primary care.