ABSTRACT
First-line treatment in anxiety disorders .................................................... 325 Treatment resistance in anxiety disorders .................................................. 327 Evidence-based management of treatment-resistant
anxiety disorders ....................................................................................... 328 Combined CBT and pharmacotherapy
in treatment-resistant anxiety disorders ................................................ 335 References ........................................................................................................ 340
Approximately one out of three people will meet DSM-IV-TR (American Psychiatric Association, 2000) criteria for an anxiety disorder at some point in their lifetime. Response rates from randomized controlled trials (RCTs) are on the order of 40 to 90% for pharmacotherapy and psychotherapy. Reported remission rates are signicantly lower (20 to 47%) (Ballenger, 1999). A majority of patients suffer from residual symptoms that are associated with poor functional outcomes, as well as comorbidity with other disorders, particularly major depression and alcohol abuse (Sanderson, DiNardo, Rapee, & Barlow, 1990).
