Preventing anxiety relapse - This is one of the first studies that I have seen that finally addresses one very important question that my patients ask me, "When will I be able to stop taking my medication for Generalized Anxiety Disorder?”. I was never quite sure how to answer this many times extrapolating from my knowledge on the length of time it is necessary to keep one on antidepressant medication for the treatment of depression, which is six months to one year, I would answer them with this length of time. Now, from this study, it appears that I have some proof of greater efficacy by giving those patients this answer. It is best from the results of this study for patients to stay on the medication for a full 12 months. See my views on anxiety for more information on my clinical and practical observations.
I have seen patients who have wanted to try to come off their medication for the treatment of Generalized Anxiety prior to the 12 month interval. What tends to happen with tapers on the medication is that the symptoms of anxiety just reappear with the subtraction of the medication; but when patients have been on the main treatment with an antidepressant for treatment of either Major Depressive Disorder or Generalized Anxiety Disorder (yes, we do treat Generalized Anxiety with antidepressants too), for a full 12 months and are symptom free, if they have only had one episode, sometimes the patients are in remission and they remain symptom-free with a taper off the medication.
I would not recommend going off the medication all at once. I would recommend a taper off the medication with the help of your doctor.
Too often the patient starts to feel better and stops taking the medicine and ends up in relapse. One of the biggest issues a psychiatrist faces is having patients staying on their medications. Many of them feel an aversion to medicine due to side effects, cost, biases against medicine, or simply because they think they are "cured". Sometimes patients with chronic anxiety can taper over time and even learn to cope with the stress and triggers in life and get to a point of taking the medication as needed. But this is often the exception and even if this is the goal; they should taper at their Dr's. advice and rate and not their own. However, it is my opinion that severe the anxiety the patient should be on medication for at least 12 months before any changes are even considered.
Patients with chronic generalized anxiety disorder (GAD) who are receiving antidepressant therapy need to be continuously treated for at least 12 months to prevent relapse, according to a new study. "Clinicians should not be afraid to treat their chronically anxious patients for at least 12 months and probably even longer," lead study author Karl Rickels, MD, Stuart and Emily Mudd Professor of Psychiatry at University of Pennsylvania, Philadelphia, told Medscape Medical News."Full remission of symptoms should be the treatment goal, and this goal is not reached for many patients unless they are treated for at least 6 months."
Read the complete article: Anxiety Relapse
Los Angeles Psychiatrist