A Guide To What Works For Anxiety Disorders - Mental Health First Aid

OCDThere have been three good-quality studies that have given 66 adultswith OCD either actual TMS or a sham treatment. In each study, therewas no difference in OCD symptoms between the active and the shamTMS groups at the end of the treatments.Other anxiety disordersThere is no evidence on whether TMS works for Social Phobia orSpecific Phobias.Vagus Nerve Stimulation (VNS)Our ratingGADPanic Disorder and AgoraphobiaPTSD and ASDSpecific PhobiasSocial PhobiaOCDOur ratingARE THERE ANY RISKS?There is a risk of seizure with TMS. However, the risk is low. Theeffects of TMS on memory, attention and concentration are not yetunderstood.RECOMMENDATIONThe current evidence from three small studies suggests that TMS is noteffective for the treatment of OCD. Two studies suggest that it may be apromising treatment for PTSD. There is not enough evidence yet to saywhether TMS is an effective treatment for other forms of anxiety disorder.WHAT IS IT?VNS is a type of brain stimulation. It requires surgery to insert a device(like a ‘pacemaker’) and wiring under the skin in the chest and neck.This sends electric signals to the vagus nerve, which is connected tothe brain. VNS has been used mostly for people with severe depressionor epilepsy.HOW IS IT MEANT TO WORK?This is unclear, but it is thought to affect brain chemistry and blood flowto different parts of the brain.DOES IT WORK?There has been only one low-quality study of VNS in people whoseanxiety disorders had not responded to previous medications orpsychological treatments. VNS devices were implanted in seven peoplewith OCD, two with PTSD and one with Panic Disorder. All were allowedto keep using any medications they were receiving. The results showedthat only three people improved by the end of the study (12 weeks). Thestudy was low-quality because VNS was not compared to no treatmentor fake treatment (e.g. ‘sham’ VNS).Other anxiety disordersThere is no evidence on whether VNS works for GAD, Social Phobia orSpecific Phobias.ARE THERE ANY RISKS?As surgery is involved in VNS, it is a highly invasive procedure. Voicechanges are common, and neck pain can also occur.RECOMMENDATIONThere is not enough evidence to say whether or not VNS worksfor anxiety disorders. Given the risks and side-effects, it is not arecommended treatment.24