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The Place of Antipsychotics in the Therapy of Anxiety Disorders and Obsessive-Compulsive Disorders

Abstract

Purpose of Review

The purpose of this review was to assess and present the findings up to this date on the efficacy of antipsychotics in the treatment of generalized anxiety disorders (GAD), social anxiety disorders (SAD), panic disorders (PD), and obsessive-compulsive disorders (OCD), mostly based on published randomized controlled trials (RCTs) or on open-label studies when RCT were lacking.

Recent Findings

Quetiapine could be recommended in patients with GAD. The efficacy of aripiprazole in two open-label studies on patients with antidepressant-refractory GAD should be assessed in RCTs. Despite preliminary positive results in open studies, there are currently no strong evidence for the effectiveness of antipsychotics in refractory SAD and in refractory PD. Conversely, risperidone and aripiprazole can be used for the treatment of refractory OCD as augmentation agents to antidepressants.

Summary

Contrary to SAD and PD, this review found evidence for the use of second-generation antipsychotics in GAD and OCD. Otherwise, first-generation antipsychotics cannot be recommended in anxiety disorders and OCD.

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References

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Acknowledgements

The authors thank Yasmina Frem for assistance and proofreading. The authors thank Dr. Friedel for reviewing the manuscript.

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Correspondence to Baptiste Pignon.

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Baptiste Pignon and Chloé Tezenas du Montcel each declare no potential conflicts of interest.

Antoine Pelissolo is a section editor for Current Psychiatry Reports.

Louise Carton reports personal fees from AstraZeneca, Indivior, and Lundbeck for talks.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Anxiety Disorders

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Pignon, B., Tezenas du Montcel, C., Carton, L. et al. The Place of Antipsychotics in the Therapy of Anxiety Disorders and Obsessive-Compulsive Disorders. Curr Psychiatry Rep 19, 103 (2017). https://doi.org/10.1007/s11920-017-0847-x

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  • DOI: https://doi.org/10.1007/s11920-017-0847-x

Keywords

  • Generalized anxiety disorders
  • Social anxiety disorders
  • Panic disorder
  • Obsessive-compulsive disorders
  • First-generation antipsychotics
  • Second-generation antipsychotics