Epidemiology of anxiety disorders and drug prescription in a primary care setting shows high potential for homeopathy

Abstract

Introduction: Anxiety disorders (AD) have become the most prevalent psychiatric disorders in the general population and the number of cases coming to the primary care physician is increasing in recent years. This study aims to determine the clinical-epidemiological profile of these patients and to know the true of their management in the Primary Care setting as well as the impact of the different treatments on their short-term evolution. Materials and methods: Epidemiological survey completed by 15 investigators in the Primary Care setting who had declared to be familiarized with homeopathic drugs, with a total of 110 recruited patients followed in three scheduled visits during 60 days of follow-up. The following data were collected from patients: clinical-epidemiological data, history of AD, information on pharmacological and adjuvant treatments, assessment of the level of anxiety (Hamilton-HAM anxiety scale), the anxiety status perceived by the patient (Visual Analogue Scale - VAS) and evolution of the general state of well-being (using the Clinical Global Impression Scale - CGIC). Results: The mean age of the population studied was 42.5 years (n = 108) and 70% were female. Thirty seven percent (37%) of patients presented a first-degree family history of AD. The most frequent AD were, generalized anxiety disorder (32.7%) and panic disorder (30%). Psychological comorbidity in AD fluctuates from the initial 19% to 38.9% in the bimonthly assessment, being the most frequent association the generalized anxiety disorder with the panic disorder. The use of combination treatments was predominant over monotherapy and the most frequent combination (27.3%) was selective serotonin reuptake inhibitors (SSRI) in combination with benzodiazepine (BZD) and Sedatif-PC (SPC), the most common homeopathic treatment. Homeopathy was used by 74.5% of patients and 50% used other adjuvant treatments. Compliance was highest in the SPC group with only 1 discontinuation due to adverse effects. The administration of treatment caused an improvement in CGI-C in all groups studied that increased after 2 months follow-up. Conclusions: AD affects women more frequently than men and prevalence rates are high in midlife and in subjects with a first degree family history of AD. Psychological comorbidities among these disorders are frequent and increase with time, being generalized anxiety disorder and panic disorder the main reasons for consultation in the Primary care setting. The most frequently used pharmacological treatment is the combination of SSRI + Benzodiazepines + SPC. A quarter of the patients used other adjuvant treatments and half of them used other therapies. Overall clinical evolution was favourable for the patients under any of the treatments. SPC showed an excellent adherence to treatment due to a good safety profile and they have presented a favourable clinical evolution as a monotherapy or in combination, so Sedatif-PC could be an interesting treatment option for the patients with anxiety disorders.