€¢ Selective serotonin reuptake inhibitors (SSRIs) are widely considered to be first-line treatments for anxiety disorders and OCD if drug therapy is chosen. Citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline are SSRIs

€¢ The serotonin and noradrenaline reuptake inhibitors (SNRIs) duloxetine and venlafaxine are effective in the treatment of certain anxiety disorders and are used as an alternative to SSRIs in some conditions

€¢ Certain tricyclic anti-depressants are used in the treatment of some anxiety disorders, but since they have more troublesome adverse effects than SSRIs and SNRIs, they are generally reserved for use in patients unresponsive to, or poorly tolerant of, a SSRI or SNRI. The monoamine-oxidase inhibitor phenelzine is efficacious in the treatment of panic disorder and social anxiety disorder, but adverse effects and the need for dietary restrictions mean it is only usually used when other treatments are ineffective

€¢ Moclobemide (a reversible monoamine-oxidase A inhibitor) is licensed for the treatment of patients with social anxiety disorder. Agomelatine has proven efficacy in generalised anxiety disorder (an unlicensed use)

€¢ Some benzodiazepines have proven efficacy in the treatment of certain anxiety disorders, but their troublesome adverse effects (sedation and cognitive impairment) and the propensity for tolerance and dependence with long-term use means they are not used routinely for the treatment
of anxiety

€¢ Pregabalin is licensed for the treatment of generalised anxiety disorder and social anxiety disorder. It commonly causes drowsiness and dizziness, and weight gain is reported in around 20 per cent of patients on long-term therapy

€¢ Beta blockers are sometimes used to manage the physical symptoms of anxiety (sometimes in combination with SSRIs), but there is little supportive evidence on
their use

€¢ Certain types of psychotherapy (including CBT) have been shown to be effective in the treatment of anxiety disorders.