Expert opinion on the prescription practice of paroxetine for the treatment of anxiety disorders in Indian settings

Abstract

Objective; To gather expert opinion regarding prescription practices and management strategies for anxiety disorders with a special focus on paroxetine among clinicians in Indian settings. Methodology: The cross-sectional study utilized a 19-item, multiple-response questionnaire to gather expert opinions from specialists in managing anxiety disorders. The survey encompassed questions about current prescription practices, clinical observations, preferences, and experiences related to managing anxiety disorders in routine settings. Descriptive statistics were used to analyze the data. Results: This study included 414 experts, with a significant proportion (92.51%) reporting that the selective serotonin reuptake inhibitors (SSRIs) class of anxiolytics manage well for patients with generalized anxiety disorder. Nearly half (50.48%) of the participants reported paroxetine as the most effective SSRI for managing generalized anxiety disorder. Sexual disturbances were reported by 51% of clinicians as the most common side effect of paroxetine leading to discontinuation or switching to another drug. More than half (68.6%) of the clinicians indicated depression as the most common comorbidity associated with anxiety disorder. About 89% of clinicians stated that combining a benzodiazepine with an SSRI during the first week of treatment was necessary. According to 81% of the participants, there was a strong positive association between early responders and achieving full remission. As indicated by 40% of the experts, the most common reasons for patients switching from other SSRIs to paroxetine were adverse effects and lack of efficacy. As reported by 48% and 47% of the clinicians, respectively, the preferred doses for paroxetine in treating anxiety disorder were 25 mg and 12.5 mg. Conclusion: The survey findings indicated that SSRIs, particularly paroxetine, were preferred for treating generalized anxiety disorder in Indian settings. Depression was frequently comorbid with anxiety disorders, and combining benzodiazepines with SSRIs was commonly practiced during the initial treatment phase.