Multiple studies have assessed the effects of antipsychotics in anxiety disorders.1 In patients with GAD, 2 studies showed that olanzapine, ziprasidone, and quetiapine achieved higher response rates (as measured using the Hamilton Anxiety rating scale [HAM-A]) vs placebo.1 In 4 studies of patients with social anxiety disorder, treatment with atypical antipsychotics was associated with higher response rates (as measured using the Clinician Global Impression – Improvement tool) than placebo, but the difference was statistically significant only in 1 study.1 One randomized controlled trial compared risperidone and paroxetine in patients with panic disorder, with similar decreases in HAM-A score in both groups.1 Separately, in 2 open-label studies in patients with panic disorder, the addition of olanzapine to selective serotonin reuptake inhibitors reduced the number of panic attacks, but this was not observed in a third study.1
In the umbrella review, 5 systematic reviews showed that quetiapine monotherapy significantly reduced the risk of recurrent episodes of anxiety disorders compared with placebo.2 There was little evidence available for other antipsychotics in anxiety disorders.2
References:
1. Vulink NC, Figee M, Denys D. Review of atypical antipsychotics in anxiety. Eur Neuropsychopharmacol 2011; 21 (6): 429–449.