The effect of treating generalized anxiety disorder on psychoactive substance abuse and dependency in Erbil city

  • Diyar Hussein Tahir M.B. Ch. B. / F.I.C.M.S. (Psych), College of Medicine, Hawler Medical University.
  • Baran Kamal Albarazanjy M.B.Ch.B. /D.G.O. /M. Sc. Com. Med., College of Medicine, Hawler Medical University.
  • Sirwan Kamil Ali M.B.Ch.B. / F.I.C.M.S. (Psych), College of Medicine, Hawler Medical University.
Keywords: Generalized anxiety disorder, abuse, dependency


Background & objectives: Generalized anxiety disorder is a common psychiatric disorder; it may act as a risk factor for psychoactive substance abuse and dependency development. The objectives are to assess the degree of abuse and dependency in generalized anxiety disorder patients, and the effect of treating the disorder on substances abuse and dependency. 

Methods: 120 patients with generalized anxiety disorder, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), were studied from January 2007 to June 2008 for the presence of psychoactive substance abuse and dependency according to DSM-IV.  All cases were managed for six months by the tricyclic antidepressant imipramine (35-75mg/day), with counseling to decrease anxiety by reassurance and anxiety management including relaxation training, in addition to supporting and encouraging the patients with abuse to stop the used psychoactive substances by a tapering schedule over weeks.

Results: Substance abuse were presents in 32.5% of patients (tobacco 17.5%, benzodiazepines 13.3%, and alcohol 1.7%), this rate decreased to 13.3% (tobacco 11.7%, benzodiazepines 0.8%, and alcohol 0.8%) six months after starting treatment. The decrease in benzodiazepines abuse and dependency was greater than that in tobacco or alcohol.

Conclusion: Generalized anxiety disorder appears to encourage abuse on psychoactive substances. Treating the disorder decreases abuse and using imipramine appears to have a good therapeutic effect on generalized anxiety disorder with low risk for abuse.


- Robert J. Waldinger. Psychiatry for medical students. American psychiatric press, 1997, 3; 197-200.

- Michael Gelder, Richard Mayou, and John Geddes. Psychiatry, an Oxford core text. Oxford university press, 2000, 2; 107.

- Michael J. Muphy & Ronald L. Cowan. Psychiatry- Blueprints. Lippincott Williams & wilkins. 20007, 4; 20.

- Benjamin J. Sadock & Virginia A. Sadock. Kaplan & Sadock’s pocket handbook of clinical psychiatry. 2005,4; 177-182.

- W.H.O., Lexicon of psychiatry & mental health terms, 1994, 2; 11.

- Menezes P.R., Johnson S., Thornicroft G., Drug and alcohol problems among individuals with severe mental illness in South London. British Journal of Psychiatry, 1996; 168: 612-619.

- Barbara Fadem. Behavioral science in medicine. Lippincott Williams & Wilkins. 2004, 1; 227.

- David Taylor, Carol Paton & Robert Kerwin. Prescribing guidelines. Taylor & francis group. 2005, 8; 186-188.

- American psychiatric association. Diagnostic and statistical manual of mental disorders, forth edition. Published by American psychiatric association, washington, seven printing, February 1998: 181-183 and 436

- W.H.O., Lexon of alcohol & drug terms, 1994; 48.

- Whalley, L.J. Neuropharmacology & Neuroendocrinology. Kandell, R.E., Zeally, A.K., Companian to psychiatric studies, Churchill Livingstone press, 1993, 5, 105-144.

- Brady, K.T. & Lydiard R.B. The association of alcoholism & anxiety, Psychiatr. Q., 1993 summer; 64(2); 136-149. Medline (R).

- Atkinson R.L., Atkinson P.C., Smith E., Bem D. & Hoeksema N. Hilgard introduction to psychology. Harcourt brace & company press. 1996, 2, 199-209.

- Rickels K, et al. Imipramine and buspirone in treatment of patients with generalized anxiety disorder who are discontinuing long-term benzodiazepine therapy. Am J Psychiatry 2000 Dec; 157(12):1973-9.

- Michael Gelder, Richard Mayou & Philip Cowen. Shorter oxford textbook of psychiatry. Oxford university press, 2001, 4; 226-240 & 570.

How to Cite
Tahir, D., Albarazanjy, B., & Ali, S. (2018). The effect of treating generalized anxiety disorder on psychoactive substance abuse and dependency in Erbil city. Zanco Journal of Medical Sciences (Zanco J Med Sci), 14(1), 42 - 46. Retrieved from
Original Articles