Pharmacologic Treatment of Anxiety Disorders in 1989 Versus 1996: Results From the Harvard/Brown Anxiety Disorders Research Program

Objective: This article reports on thepharmacologic treatment of patients diagnosed with generalizedanxiety disorder (GAD) enrolled in a naturalistic long-term studyof anxiety disorders, with enrollment in 1989 through 1991 andfollow-up in 1996.

Method: 711 patients were enrolled in the studyduring 1989-1991. At intake, 167 patients met DSM-III-R criteriafor GAD; at 1996 follow-up, 103 patients met these criteria. Thepatients were divided into 3 groups by diagnosis: GAD alone (N =18 at intake, N = 11 at follow-up), GAD comorbid with anotheranxiety disorder (N = 84 at intake, N = 52 at follow-up), and GADcomorbid with Research Diagnostic Criteria-defined majordepressive disorder, with or without another anxiety disorder (N= 65 at intake, N = 40 at follow-up). The groups were evaluatedat intake and follow-up on whether they received medication andthe types of medication they received.

Results: Nearly one third of patients in the1989-1991 sample were not receiving any medication for treatmentof their anxiety disorder; in 1996, 27% of patients still werereceiving no medication. There was a decrease in benzodiazepinetreatment and an increase in antidepressant treatment in 1996 forGAD patients who did not have comorbid depression or anotheranxiety disorder.

Conclusion: The finding of one quarter to onethird of patients with GAD receiving no medication is consistentwith previous observations of undertreatment of depression. Thefindings on medication type suggest a shift in the type ofmedications being prescribed for treatment of GAD from exclusivebenzodiazepine treatment to the combination of benzodiazepine andantidepressant treatment.