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Prof. Borwin Bandelow

Borwin Bandelow psiquiatra Controversias Psiquiatría Barcelona
Universitätsmedizin Göttingen, Alemania
Ponencia Trastornos de ansiedad resistentes al tratamiento
Fecha Sábado, 27 de Abril, 2019
Hora 11:00 a 11:45


Borwin Bandelow, MD, PhD is Professor of Psychiatry and Psychotherapy at the University of Göttingen in Göttingen, Germany. He is currently working as Senior Scientist at the Department of Psychiatry and Psychotherapy. As a specialist for psychiatry and neurology, a psychologist, and a psychotherapist, Dr. Bandelow specializes mainly in the field of anxiety disorders, but also in depression, schizophrenia, psychotherapy and psychopharmacology.

He (co-)authored over 320 publications internationally in books and journals (h-factor 40). He has given scientific presentations in 40 countries. He has written or edited a number of books, e.g. "Social Anxiety Disorder" (Taylor & Francis, 2004) or "Panic Disorder and Agoraphobia" (Oxford University Press, 2014). His basic research includes studies on assessment, neurobiology, and treatment of anxiety disorders, psychotherapy and on the side effects of neuroleptic drugs.

He is author or coauthor of a number of international and national guidelines for the treatment of anxiety disorders, obsessive–compulsive disorder and posttraumatic stress disorder.

He has written a number of books on psychiatric topics for the general public, including "The Anxiety Book" and "Celebrities", "Who is Afraid of the Big Bad Wolf?" all of which became bestsellers and were translated into several languages. He is the Chair of Anxiety Disorders Research Network (ADRN) of the ECNP (European College of Neuropsychopharmacology).

Dr Bandelow is a member of the EAP (European Association of Psychiatry), the ECNP (European College of Neuropsychopharmacology), the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force on Treatment Guidelines for Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders.


Anxiety disorders (panic disorder, generalized anxiety disorder, and social anxiety disorder) are chronic, disabling conditions with high prevalence rates. Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) are standard treatments for anxiety disorders, and pregabalin is a new treatment option for generalized anxiety disorder (1). Second-line treatments include tricyclic antidepressants (TCAs), which are equally effective, but they are less well tolerated than the SSRIs. For short-term treatment of treatment-resistant cases, benzodiazepines like alprazolam may be used when the patient does not have a history of dependency and tolerance.

There are almost no randomised studies for switching strategies. However, there are many treatment options for patients not responding to standard treatments (2). First, a switch to another first line treatment should be attempted. Then, second-line treatments may be tried. Third line treatments include the MAO inhibitor phenelzine. Then, drugs which are not licensed for a specific anxiety disorder, but shall clinical data in other anxiety disorders may be used. Augmentation strategies have also not been investigated in randomised studies, with the exception of the combination of SSRIs and benzodiazepines. Pregabalin may be added to SSRIs or SNRIs, because they the lower interaction potential between these drugs. When using off label medications, medicolegal issues may arise.

Although controlled data are almost completely lacking, the addition of cognitive behaviour therapy (CBT) can be recommended in most treatment resistant cases. However, according to meta-analytical data, drugs yield higher pre-post-effect sizes than CBT and other psychological therapies (3). Some studies showed that CBT-resistant patients with panic disorder have improved with antidepressants.


[web] Bandelow B, Michaelis S, Wedekind D (2017). Treatment of anxiety disorders. Dialogues Clin Neurosci. 2017 Jun;19(2):93-107.

[PDF] Bandelow B et al (2015). Efficacy of treatments for anxiety disorders: a meta-analysis. Int Clin Psychopharmacol. 2015 Jul;30(4):183-92. doi: 10.1097/YIC.0000000000000078.

[web] Bandelow B, Rüther E. (2004). Treatment-resistant panic disorder. CNS Spectr. 2004 Oct;9(10):725-39.