New studies confirm MAO inhibitors' efficacy in treating severe anxiety
Benzodiazepine derivatives may no longer be the treatment of choice for the most extreme and intractable anxiety. In fact, those most in need of calmative therapy—patients with severe chronic phobias and panic disorders—are least likely to respond to these drugs. Diazepam and its cousins, however, remain useful agents for treating more mundane anxieties.For the treatment of extreme angst, antidepressants are finding growing favor. A few years ago, the news broke that tricyclics often benefit profoundly anxious persons such as those with agoraphobia. Now, a large, controlled double-blind study nearing completion confirms the lesser-known finding that monoamine oxidase inhibitors (MAOIs)—which retard amine metabolism in the brain—probably provide even more efficacious and specific therapy for the anxieties that besiege these patients.The MAOIs still are used principally by specialists with considerable expertise in psychopharmacology because of their severe potential toxicity.