May 1991

A Practical Update on Anxiety Disorders and Their Pharmacologic Treatment

Author Affiliations

From the Department of Clinical Pharmacy (Drs Brown and Wells), the Anxiety Disorders Program (Dr Downs), and the Section of Affective Disorders (Dr Akiskal), Department of Psychiatry (Dr Wells), and the Department of Pharmacology (Dr Akiskal), University of Tennessee at Memphis; and the Department of Family Medicine, Baylor College of Medicine at Houston (Tex) (Dr Rakel).

Arch Intern Med. 1991;151(5):873-884. doi:10.1001/archinte.1991.00400050027007

Anxiety disorders are among the most common psychiatric conditions.1 Like depressive and substance use disorders, with which they often coexist, they begin early in life. At least 5% of the US population (12 million people) annually experience anxiety severe enough to seek treatment.2 Anxious individuals are heavy users of the health care system, accounting for 10% to 15% of patient visits to internal medicine and cardiology practices.3 Therefore, this review, which summarizes recent advances in anxiety disorders, is relevant to all physicians.

When evaluating an anxious patient, the physician must first decide whether the anxiety is an appropriate response to a threatening situation or represents a pathologic entity. If the latter, the physician should then determine if it is due to a medical condition known to cause anxiety or if it is the manifestation of a psychiatric disorder. Finally, the condition should be assigned to a specific

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