Anxiety disorders: a review of tricyclic antidepressants and selective serotonin reuptake inhibitors

Abstract

Zohar J, Westenberg HGM. Anxiety disorders: a review of tricyclic antidepressants and selective serotonin reuptake inhibitors. Acta Psychiatr Scand 2000: 101: 39–49. © Munksgaard 2000. Objective: Anxiety disorders are the most common mental health disorders. While the older tricylic antidepressants (TCAs) are efficacious in the treatment of many anxiety disorders, recent studies with fluoxetine and other selective serotonin reuptake inhibitors (SSRIs) have emphasized the role of serotonin in the aetiology of these conditions. Method: We reviewed the efficacy, safety and tolerability of TCAs and SSRIs in the treatment of the most common anxiety disorders, specifically, panic disorder, obsessive‐compulsive disorder, post‐traumatic stress disorder, social phobia and generalized anxiety disorder. Results: Both the TCA and SSRI antidepressants are effective in treating a wide variety of anxiety disorders. SSRIs, due to their greater safety and tolerability, should be the preferred choices in treating anxiety disorders in those instances where TCAs and SSRIs are considered equally effective. In the cases of OCD and social phobia, SSRIs are almost always preferable given that the TCAs do not appear effective in these disorders. Conclusion: Further research is needed on the naturalistic long‐term use of the TCAs and SSRIs in the treatment of anxiety disorders.

The Mouse Defense Test Battery: pharmacological and behavioral assays for anxiety and panic

“…Furthermore, some of these compounds (i.e. imipramine, fluoxetine, and phenelzine) partially affected defensive threat/attack responses and/or risk assessment activities, effects that may also corroborate clinical findings showing that these drugs have a broad spectrum of therapeutic activity against anxiety disorders (Modigh, 1987;Zohar and Westenberg, 2000). In addition, the finding of a potentiation in some defense reactions (i.e.…”

The Gerbil Elevated Plus-Maze I Behavioral Characterization and Pharmacological Validation

“…Furthermore, paroxetine appeared the most potent with anxiolyticlike effects at a 10 mg/kg dose, rather than the 30 mg/ kg doses of imipramine and fluoxetine. Recently, paroxetine has been approved for the treatment of social phobia (Schatzberg 2000;Zohar and Westenberg 2000) and is currently in clinical trials for the treatment of Generalized Anxiety Disorder (GAD). The data in the present study support the potential anti-anxiety effects of paroxetine by demonstrating the acute anxiolyticlike effects of the drug in an elevated plus-maze that exploits neophobia in animals.…”

Association study of the serotonin transporter promoter polymorphism and symptomatology and antidepressant response in major depressive disorders

“…7 In addition, SSRIs have recently been widely used for anxiety disorders such as panic and obsessive-compulsive disorder, social phobia and generalized anxiety disorder. 20 It would be of interest to test whether the 5-HTTLPR polymorphism may also be a predictor for efficacy of SSRI treatment for these dysfunctions.…”