OBJECTIVES: To compare "homeopathic drugs" strategy (strategy H) with "psychotropic drugs" strategy (strategy P) for treating anxiety disorders in France, in terms of effectiveness, satisfaction, and costs. METHODS: Effectiveness, satisfaction, and economic data were derived from a 3-month pragmatic prospective study including 394 patients which were "male or female over 18, who consulted a homeopathic or non-homeopathic GP for the first time for symptoms of anxiety disorders such as defined by the DSM IV". Strategy H included 135 patients that received at least one homeopathic drug and no psychotropic drugs, and strategy P 185 patients that received at least one psychotropic drug and no homeopathic drugs. In both strategies, other drugs could have been prescribed (trace elements, etc). Effectiveness was assessed by GPs using the "Hamilton Anxiety Scale", and by patients using the "Spielberger State Trait Anxiety Inventory". Satisfaction of GPs and patients was evaluated using the "Likert Scale". Direct medical costs (medical visits, medication, additional tests) were assessed from the national health insurance system viewpoint, using public prices and French Social Security tariffs. We checked the comparability of patient population and performed appropriate statistical tests: Chi-Square test for qualitative variables, and Student, Mann-Whitney, Kolmogorov-Smirnov tests for quantitative variables. RESULTS: The "homeopathic drugs" strategy was statistically equivalent to the "psychotropic drugs" strategy in terms of effectiveness (absolute variation of Hamilton score: 13.11 vs 13.02, absolute variation of Spielberger Ya and Yb scores: 14.85 vs 18.65 and 10.41 vs 13.28 respectively) and satisfaction (no statistical differences), for significantly lower direct medical costs reimbursed by the national health insurance system (53.46€ vs 65.75€). CONCLUSION: Homeopathic drugs could constitute a cost-effective alternative to psychotropic drugs for treating anxiety disorders, and so could provide an answer to public health and economic problems posed by these drugs in France.