The WFSBP recommends either an SSRI or venlafaxine as first-line pharmacological treatment, with pregabalin as a second-line option.1 Numerous other psychotropic agents are included as further options for when standard treatment have failed or are not tolerated, including the monoamine oxidase inhibitor phenelzine, benzodiazepines, mirtazapine, gabapentin, and ketamine.1
References:
1. Bandelow B, Allgulander C, Baldwin DS, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders – Version 3. Part I: Anxiety disorders. World J Biol Psychiatry 2023; 24 (2): 79–117.
2. Leichsenring F, Steinert C, Rabung S, Ioannidis JPA. The efficacy of psychotherapies and pharmacotherapies for mental disorders in adults: an umbrella review and meta-analytic evaluation of recent meta-analyses. World Psychiatry 2022; 21 (1): 133‒145.
3. Batelaan NM, Bosman RC, Muntingh A, et al. Risk of relapse after antidepressant discontinuation in anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder: systematic review and meta-analysis of relapse prevention trials. BMJ 2017; 358: j3927.
