Escitalopram, sertraline and duloxetine in the pharmacotherapy of anxiety disorders – practical guides for individualized drug selection by primary care physicians

The paper presents the profiles of action of escitalopram, sertraline, and duloxetine in the treatment of anxiety disorders. The fundamental assumption underlying the proposed method of profiling the selection of medication for individual needs of the patient is clinical observation that different substances belonging to the category of ‘antidepressants’ or characterized as having ‘anxiolytic effects’ have specific profiles of action on the psychological functions of the individuals taking them. These observed profiles of action of different substances reflect their diverse actions at the biological level.

The paper practically presents proposals for discussing the expected effects of treatment (the impact of each listed above drug on psychological functions), the way to conduct conversations, the scope of topics that should be addressed, and emphasizes the necessity of discussing psychological and subjective aspects of treatment. It also discusses the most important issues that should be addressed during the second subsequent visit of the patient.

Conducting pharmacotherapy for individuals with anxiety disorders requires an individualized selection of medication and consideration of several aspects, including psychological ones, which influence treatment outcomes. These psychological aspects should be taken into account during the conversation with the each patient.