How effective are current drug treatments for anxiety disorders, and how could they be improved?

Although there are many psychotropic drugs and psychotherapies available for the treatment of patients with anxiety disorders, overall clinical outcomes and the standard of care for most patients with these common, persistent and impairing illnesses are usually far from optimal. The disorders typically follow a chronic or recurring course in which full symptomatic remission is uncommon; they are associated with the temporal accumulation of comorbid disorders and with an increased suicide risk; and treatment responsiveness may diminish over time. This chapter examines the efficacy of current pharmacological treatments in the three main anxiety disorders – generalised anxiety disorder (GAD), panic disorder andsocial anxiety disorder (social phobia) – and summarises how clinical outcomes might be improved by anumber of alternative approaches, including the enhanced use of existing treatments, modifications toexisting psychotropic drugs and the development of new targets for anxiolytic pharmacotherapy. It also describes how advances in genetics and neuroscience might lead towards more individualised drug treatments, whilst recognising that theoretical treatment advances can only improve outcomes if used rationally, in collaboration with the patient