Professional Alternatives to BZRAs
The second group of treatments for anxiety is administered under professional direction. These include:
- Cognitive Behavioral Therapy (CBT) 1-14
- Acceptance and Commitment Therapy (ACT) 15-18
- Acupuncture (weak evidence) 19
- Massage 20-23
Note that CBT and ACT in particular have been shown to be as effective as benzodiazepines in reducing anxiety. 6-12
1 Craske. CBT for panic disorder. Behav Res Ther. 2007;45(6):1095-109
2 Durham. CBT for anxiety disorders LT outcomes. J Affect Disord. 2012;136(3):875-81
3 Erickson. CBT group for anxiety disorders. Psychiatr Serv. 2007;58(9):1205-11
4 Hofmann. CBT for anxiety disorders effect on QOL. J Consult Clin Psych. 2014;82(3):375-91
5 Hofmann. CBT for adult anxiety disorders meta-analysis. J Clin Psych. 2008;69(4):621-32
6 Kaczkurkin. CBT for anxiety disorders update. Dialogues Clin Neurosci. 2015;17(3):337-46
7 Olthuis. Therapist-supported internet CBT for anxiety. Cochrane Rev. 2016;3:CD011565
8 Olatunji. CBT efficacy for anxiety meta-analysis. Psych Clin North Am. 2010;33(3):557-77
9 Westra. BZ use & CBT outcome in panic disorder. J Anxiety Disord. 2002;16(3):233-46
10 Pull. Pharmacotherapy of panic disorder. Neuropsychiatr Dis Treat. 2008;4(4):779-95
11 Otto. BZ & CBT for anxiety disorders. J Clin Psych. 2005;66 Suppl 2:34-8
12 Heuzenroeder. GAD, panic psych & med cost-effectiveness. Aust N Z J Psych. 2004;38(8):602-12
13 Imai. Psych v med Rx for panic disorder. Cochrane Rev. 2016;10:CD011170
14 van Balkom. Panic disorder: med v CBT v combination. J Nerv Ment Dis. 1997;185(8):510-6
15 Bluett . ACT for anxiety, OCD spectrum disorders. J Anxiety Disord. 2014;28(6):612-24
16 Ducasse . Acceptance and commitment therapy. Encephale. 2015;41(1):1-9
17 Eilenberg. Group ACt for health anxiety. Dan Med J. 2016;63(10). pii: B5294
18 Swain. ACT for anxiety systematic review. Clin Psychol Rev. 2013;33(8):965-78
19 Pilkington. Acupuncture for anxiety, anxiety disorders. Acupunct Med. 2007;25(1-2):1-10
20 Chen. Back massage for anxiety. J Altern Complement Med. 2013;19(5):464-70
21 Field. Massage therapy research review. Complement Ther Clin Pract. 2014;20(4):224-9
22 Moyle. Massage effect on agitation in demented elderlyi. J Clin Nurs. 2013;22(5-6):601-10
23 Pinar. Back massage for anxiety, sleep in caregivers. Asian Pac J CA Prev. 2015;16(18):8127-33
24 Archer. Collaboration for depression, anxiety. Cochrane Rev. 2012;10:CD006525
25 Fjorback. Mindfulness and bodily distress. Dan Med J. 2012;59(11):B4547
26 Hofmann. Adding meds to CBT for anxiety disorders. Int J Cogn Ther. 2009;2(2):160-75
