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A condition marked by excessive worry and feelings of fear, dread, and uneasiness that last six months or longer.

Results: 20

Valerian for anxiety disorders

Anxiety disorders are a very common mental health problem in the community. Most of the medications used to treat anxiety have side effects. Valerian is a phytotherapeutic medication frequently used for insomnia. The aim of this study was to investigate the efficacy and safety of valerian for anxiety disorders. Only one study was identified, involving 36 patients and comparing valerian with placebo and diazepam. This study found no significant differences in effectiveness between valerian and placebo, or between valerian and diazepam, for clinician‐rated anxiety symptoms, and that both valerian and diazepam were equally well tolerated by patients. However, additional studies with larger numbers of patients are necessary before drawing conclusions about the effectiveness and safety of valerian as a treatment option for anxiety disorders.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Second‐generation antipsychotic drugs for anxiety disorders 

Anxiety disorders are a prevalent and disabling condition. Because of high rates of treatment resistance, there is interest in new pharmacological treatment options such as second‐generation antipsychotics. This systematic review evaluated the efficacy and tolerability of second‐generation antipsychotics in the treatment of anxiety disorders. We found eleven randomised placebo‐controlled trials, comparing quetiapine, olanzapine and risperidone with placebo and antidepressants. The vast majority of the available data was on quetiapine (> 3000 participants). Participants with generalised anxiety disorder responded significantly better to quetiapine than to placebo, measured as a reduction in the Hamilton Anxiety Scale (HAM‐A). Participants treated with quetiapine were more likely to drop out due to adverse events, to gain weight, to suffer from sedation or to suffer from extrapyramidal side effects. The evidence on the other second‐generation antipsychotics is currently too limited to draw any conclusions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Azapirones for generalized anxiety disorder (GAD)

Generalized anxiety disorder is one of the most common anxiety disorders and can be costly if unrecognized or left untreated. Azapirones are a group of drugs that work at the 5‐HT1A receptor and are used to treat patients suffering from GAD. This systematic review evaluates the effectiveness of azapirones compared to other treatments. From the results of 36 randomized controlled trials, azapirones appear to be superior to placebo in short‐term studies (four to nine weeks) but may not be superior to benzodiazepines. We were unable to conclude if azapirones were superior to antidepressants, psychotherapy or kava kava. As GAD is generally chronic in nature, conclusions about azapirones' long‐term efficacy are not able to be made and longer term trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Hydroxyzine for generalised anxiety disorder

Hydroxyzine is an anti‐histamine medication that has been studied in anxiety disorders. This review shows that hydroxyzine is better than placebo in terms of anxiety symptoms in individuals with generalised anxiety disorder (GAD). Too few data were available to be able to draw any conclusions about the efficacy and tolerability of hydroxyzine compared with benzodiazepines and buspirone. Given the robust evidence for the efficacy of antidepressants for GAD, these findings suggest that hydroxyzine should not be recommended as first‐line treatment GAD.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Psychological therapies for people with generalised anxiety disorder

Generalised anxiety disorder (GAD) is a very common condition, in which people suffer from excessive worry or anxiety about everyday events and problems. Psychological therapies are a popular form of treatment for anxiety disorders. This review aimed to find out whether psychological therapies are effective for GAD, and whether cognitive behavioural therapy (CBT) is more effective than other psychological therapy approaches, including psychodynamic and supportive therapies. The review included 25 studies, with a total of 1305 participants. All the studies used a CBT approach, and compared CBT against treatment as usual or waiting list (13 studies), or against another psychological therapy (12 studies). The review showed that people attending for psychological therapy based on a CBT approach were more likely to have reduced anxiety at the end of treatment than people who received treatment as usual or were on a waiting list for therapy. CBT was also very effective in reducing secondary symptoms of worry and depression. People who attended for group CBT and older people were more likely to drop out of therapy. None of the studies comparing CBT with treatment as usual or waiting list looked at the long‐term effectiveness of CBT. It is not clear whether people attending for CBT sessions were more likely to have reduced anxiety than people attending for psychodynamic therapy or supportive therapy, because only one study compared CBT with psychodynamic therapy, and the six studies that compared CBT with supportive therapy showed differing results. None of the studies included in the review reported on the possible side effects or acceptability of psychological therapies. More studies should be carried out to establish whether psychodynamic and supportive therapies are effective for GAD, and whether CBT is more helpful than other psychological therapy approaches in treating GAD.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Generalized anxiety disorder: Overview

Everyone feels scared sometimes. Fear can protect us by putting us in a state of alertness so we can react more quickly. But constantly worrying about practically everything can become a major problem. Generalized anxiety disorder could be the cause.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 13, 2014

Treatment options for generalized anxiety disorder

Generalized anxiety disorder can dominate the life of the person who has it and often persists for a long time. But there are a number of different approaches that can be learned to better manage the anxiety and cope well in everyday life. Some medications are also effective.People who have generalized anxiety disorder (GAD) are not afraid of specific things or situations, but of practically everything, which is why it is referred to as “generalizedanxiety. This can take a great emotional toll and also cause a number of physical symptoms including drowsiness, muscle tension and a racing heartbeat. Being in a state of constant worry is exhausting, but there are different treatments that can help reduce the anxiety down to a tolerable level.Unlike other kinds of anxiety disorders, generalized anxiety disorder often first develops in people between the ages of 30 and 35. But generally speaking, an anxiety disorder can affect people of all ages.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 13, 2014

Morita therapy for anxiety disorders in adults

Anxiety disorders are some of the most prevalent mental disorders. Morita therapy, a systematic psychological therapy based on eastern philosophy, has been used to treat anxiety disorders for decades. It encourages people with anxiety disorders to accept anxiety as a natural feeling, while at the same time it engages them in constructive behaviours via four phases, which sequentially are bed rest in isolation, light work, heavy work and preparation for normal daily living. Acceptance is merely redirecting attention towards purposeful behaviour. People get better when they stop trying to eliminate anxiety and fulfil their desires with study and work in their actual personal and social lives.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Medication for treating anxiety disorders in people with alcohol use problems

People with anxiety disorders and alcohol use problems, as well as their healthcare providers.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Adjustment to Cancer: Anxiety and Distress (PDQ®): Patient Version

Expert-reviewed information summary about the difficult emotional responses many cancer patients experience. This summary focuses on normal adjustment issues, psychosocial distress, and adjustment disorders.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: January 7, 2015

Internet‐based cognitive behavioural therapy with therapist support for anxiety in adults: a review of the evidence

People who suffer from anxiety and their families.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Obsessive-compulsive disorder: Overview

Some people who have obsessive-compulsive disorder constantly wash their hands because they are so afraid of germs, while others might not be able to stop counting to 20. Over time these kinds of rituals can start to dominate a person’s life. But there are treatments available to help people cope with obsessive-compulsive disorders.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 10, 2014

Consultation letters for use by primary care physicians in their care of patients with physical symptoms for which no organic cause can be found

In 10% to 35% of all consultations in primary care, no organic cause can be found for the physical symptoms of the patient. Patients may present with symptoms such as fatigue, headaches, dizziness, non‐specific low back pain and chest pain. Such symptoms can lead to frequent consultations with the physician and high medical costs as well as causing considerable worry and disability for the patient. Patients suffering from MUPS are more likely than the average patient to experience depressive and anxiety disorders. Studies have reported positive effects of screening by a psychiatrist in the treatment of MUPS in primary care. After screening, the psychiatrist sends the primary care physician a 'consultation letter' (CL) which states the diagnosis and that patients are best helped by: 1) having their symptoms taken seriously; 2) not being told their symptoms are 'all in your head'; 3) not being referred for further investigation unless there is a clear indication of a somatic disorder; 4) undergoing a physical examination at each visit; and 5) being seen at regular intervals.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Family interventions for bipolar disorder

Drug treatments are the primary treatment for bipolar disorder. Alone, however, they are not sufficient to manage the disorder. Studies on psychosocial interventions for mental disorders such as schizophrenia and anxiety show that they are effective treatments. Reports in the literature suggest that they may be useful for people with bipolar disorder as well. The role of the family is important in the care of people with bipolar disorder, with effective family functioning helping to maintain a person's psychological balance. This systematic review investigated the effectiveness of any psychosocial family intervention for people with bipolar disorder and/or their families and carers. Seven randomised controlled trials (393 participants) were included in the review, all of which evaluated psychoeducational interventions. Five studies compared family interventions against no treatment, and three studies compared one type or delivery of family intervention against another family intervention. Differences in the interventions, outcome measures and end points used in the trials did not allow us to perform a meta‐analysis. Whilst results from individual studies did not suggest a significant effect for family interventions when added to drug therapy, the studies provide insufficient evidence to draw conclusions which can be generalised to everyday practice. Further research using appropriate randomised controlled trial methodology and evaluating family interventions other than psychoeducation is called for in this under‐researched and important topic.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Azapirones versus placebo for panic disorder in adults

Panic disorder is common in the general population and is often associated with various psychiatric disorders. Azapirones are a class of drugs occasionally used in the treatment of panic disorder, although none has been approved by a regulatory agency for this purpose. They are associated with less drowsiness, psychomotor impairment, alcohol potentiation and potential for addiction or abuse. However, azapirones are not widely used for panic disorder. Evidence for their efficacy in treating panic disorder is unclear. It is important to find out if azapirones are effective and acceptable in the treatment of panic disorder.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is one of the most common and best studied forms of psychotherapy. It is a combination of two therapeutic approaches, known as cognitive therapy and behavioral therapy.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 8, 2016

Medicines for Treating Mental Health Conditions: A Review of the Research for Adults and Caregivers

This summary will tell you about research on how well some antipsychotic medicines work for conditions other than psychosis and bipolar disorder. It will also tell you about research on the risks of side effects for these medicines.

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: August 1, 2012

Duloxetine versus other antidepressive agents for depression

Although pharmacological and psychological interventions are both effective for major depression, antidepressant drugs remain the mainstay of treatment in moderate to severe major depression. During the last 20 years, newer compounds (such as selective serotonin reuptake inhibitors and dual action agents such as serotonin noradrenalin reuptake inhibitors) have progressively become the most commonly prescribed antidepressants. Duloxetine hydrochloride, one of the most recent antidepressants introduced in the market, is a selective serotonin noradrenergic reuptake inhibitor for oral administration. In the present review we assessed the evidence for the efficacy, acceptability and tolerability of duloxetine in comparison with all other antidepressants in the acute‐phase treatment of major depression. Sixteen randomised controlled trials (5735 participants) were included. Duloxetine was not more effective than some other new antidepressant agents in the acute‐phase treatment of major depression, and it was less well tolerated than escitalopram and venlafaxine as more patients allocated to duloxetine withdrew treatment before study end. However, due to the limited number of studies per comparison these results should be interpreted with caution.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Smart Health Choices: Making Sense of Health Advice

This book aims to help consumers and practitioners develop the skills to assess health advice – and hopefully to make decisions that will improve the quality of their care. For some people, making better-informed decisions could be life saving. We hope that it will be useful if you are struggling to come to terms with an illness or injury, and the best ways of managing it. Or you may simply want to lead a healthier life, and may be wondering how to make sense of the often conflicting flood of health information that deluges us every day, through the media, and from our friends and health practitioners.

Hammersmith Press.

Version: 2008

Topiramate versus carbamazepine as single drug treatment for epilepsy

Epilepsy is a common disorder of the nervous system in which abnormal electrical discharges from the brain cause recurrent seizures (physical convulsions or thought disturbances or a combination of these symptoms). We studied two types of epileptic seizures in this review: generalised‐onset seizures in which electrical discharges begin in one part of the brain and move throughout the brain, and partial‐onset seizures (also known as focal‐onset seizures) in which the seizure is generated in and affects the same part of the brain. Partial‐onset seizures may become generalised (secondary generalisation) and move from one part of the brain to throughout the brain. Up to 70% of individuals with active epilepsy have the potential to go into long‐term remission shortly after starting drug therapy and around 70% of these individuals can achieve seizure freedom using a single antiepileptic drug.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Systematic Reviews in PubMed

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Systematic Review Methods in PubMed

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