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Adjustment disorder with anxiety: Care practice

Published online by Cambridge University Press:  15 April 2020

D. Stein
D. Stein*
Affiliation:
Department of Psychiatry, Groote Schuur Hospital J2, Cape Town, South Africa
*
E-mail address: dan.stein@uct.ac.za

Abstract

Adjustment disorder with anxiety (ADWA) is a highly prevalent condition, particularly in primary care practice. Adjustment disorders significantly impair patients’ quality of life, but there are relatively few systematic treatment trials in the area of ADWA, and there are few data on predictors of treatment response. Here we review the limited pharmacotherapy data available on the treatment of ADWA. In primary care settings benzodiazepines are frequently prescribed for psychiatric symptoms, despite their adverse event profile and their potential risk for dependence. The non-benzodiazepine drug etifoxine is a promising agent insofar as it is not associated with dependence. Its efficacy and safety have been evaluated in three double-blind randomized clinical trials in comparison with non-benzodiazepine (buspirone) and benzodiazepines (lorazepam and alprazolam) . The three trials point to the anxiolytic properties of etifoxine, demonstrating an overall clinical improvement of patients, and no risk for dependence or rebound effect. In conclusion, even if benzodiazepines are often used for the treatment of ADWA, other therapeutic options are possible, with a better safety profile.

Keywords

Adjustment disorder with anxietyEtifoxine
Type
Congrès français de psychiatrie: Rencontres avec l’expert
Information
European Psychiatry , Volume 30 , Issue S2: HS1 - Congrès Français de Psychiatrie 2015 , November 2015 , pp. S8
Copyright
Copyright © European Psychiatric Association 2015

Disclosure of interest

Speaker during Biocodex Symposium Wednesday 25 November 2015 – Lille Grand Palais.

References

Servant, D.Graziani, P.L.Moyse, D.Parquet, P.J.Treatment of adjustment disorder with anxiety: efficacy and tolerance of etifoxine in a double-blind controlled study. Encephale 1998; 24: 569–574.Google Scholar
Nguyen, N.Fakra, E.Pradel, V.Jouve, E.Alquier, C.Le Guern, M.E., et al.Efficacy of etifoxine compared to lorazepam monotherapy in the treatment of patients with adjustment disorders with anxiety: a double-blind controlled study in general practice. Hum Psychopharmacol 2006; 21: 139–149.CrossRefGoogle ScholarPubMed
Stein, D.J.Etifoxine versus alprazolam for the treatment of adjustment disorder with anxiety: a randomized controlled trial. Adv Ther 2015; 32: 57–68.CrossRefGoogle ScholarPubMed
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