World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders - First revision

Borwin Bandelow, Joseph Zohar, Eric Hollander, Siegfried Kasper, Hans Jurgen Möller, Christer Allgulander, José Ayuso-Gutierrez, David S. Baldwin, Robertas Bunevicius, Giovanni Cassano, Naomi Fineberg, Loes Gabriels, Ian Hindmarch, Hisanobu Kaiya, Donald F. Klein, Malcolm Lader, Yves Lecrubier, Jean Pierre Lépine, Michael R. Liebowitz, Juan José Lopez-IborDonatella Marazziti, Euripedes C. Miguel, Kang Seob Oh, Maurice Preter, Rainer Rupprecht, Mitsumoto Sato, Vladan Starcevic, Dan J. Stein, Michael van Ameringen, Johann Vega

Research output: Contribution to journalArticlepeer-review

593 Scopus citations


In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, World J Biol Psychiatry 3:171), recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo- or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

Original languageEnglish (US)
Pages (from-to)248-312
Number of pages65
JournalWorld Journal of Biological Psychiatry
Issue number4
StatePublished - 2008
Externally publishedYes


  • Anticonvulsants
  • Antidepressants
  • Antipsychotics
  • Anxiety disorders
  • Anxiolytics
  • Benzodiazepines
  • Cognitive behaviour therapy
  • Evidence-based guidelines
  • Generalized anxiety disorder
  • Obsessive-compulsive disorder
  • Panic disorder
  • Post-traumatic stress disorder
  • SNRI
  • SSRI
  • Simple phobia
  • Social phobia
  • Treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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