Drug Treatment of Phobias

Summary

In the last decade anxiety disorders have been the focus of intensive research in the psychiatric community, resulting in a rapid growth in our understanding of these illnesses. Diagnostic, biological, and psychopharmacological investigations have revealed important distinctions among these disorders which enable the clinician to make well- informed therapeutic choices and frequently ameliorate or even eliminate anxiety symptoms and related phobic behaviour. The principles of treatment can be simply stated:

• 1. Careful diagnostic evaluation through history and exclusion of medical and psychiatric conditions which mimic anxiety disorders.

• 2. Treatment selection based on diagnosis and formulation with the patient of the goals and expected outcome of pharmacotherapy.

• 3. Systematic application of each drug treatment in sufficient dosage and for an adequate duration permitting progression to the next agent when results are not optimal.

• 4. Addition of non- pharmacological interventions, usually behavioural therapy, to decrease phobic behaviour.

• 5. Development of a maintenance or discontinuation strategy tailored to the needs of the patient.