2019 Volume 59 Issue 6 Pages 554-559
From a pharmacotherapy perspective, the pathologies classified under somatic symptom and related disorders (somatoform disorders) include obsessive-compulsiveness, anxiety or fear, and anger.
Selective serotonin reuptake inhibitors (SSRIs) are effective in obsessive-compulsiveness. When the effect of SSRIs is inadequate, augmentation therapies with antipsychotics, especially those that have high D2 receptor affinities, may be effective. When an immediate improvement is needed, combination therapies with noradrenergic and specific serotonergic antidepressant (NaSSA) may be effective.
Both benzodiazepine anxiolytics and SSRIs are effective in anxiety or fear. When these are not adequately effective, antipsychotics, especially multi-acting receptor-targeted antipsychotics (MARTAs), may be effective. α2δ ligands can also be one of the alternatives, because it can alleviate the hyperactivity of amygdala, the nucleus associated with anxiety and fear.
In some cases of anger, prescription of Japanese Kampo Medicines, particularly Yokukansan, or antipsychotics, especially MARTAs, may be considered.
