Medication | Psychosocial
Of all the anxiety disorders, only generalized anxiety disorder
has appreciable data supporting the efficacy of an agent that is
able to positively affect both anxiety symptoms and substance use.
In generalized anxiety comorbid with an AUD, buspirone has been
shown to reduce both anxiety symptoms and alcohol consumption (Nitenson and Gastfriend 2003). As a general rule for all of the other
anxiety spectrum disorders, serotonin reuptake inhibitors should
be considered first-line agents, and benzodiazepines should be avoided
as much as possible unless absolutely necessary (e.g., in the case
of severe panic disorder). If a benzodiazepine has to be used, slower-onset
and longer-acting agents should be used (e.g., clonazepam).