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Evidence-based pharmacotherapy of Generalized Anxiety Disorder

Evidence-based pharmacotherapy of Generalized Anxiety Disorder
Evidence-based pharmacotherapy of Generalized Anxiety Disorder
Generalized Anxiety Disorder (GAD) is a common and often disabling disorder. This paper reviews the pharmacological treatment of GAD, based on the findings of published meta-analyses and randomized placebo-controlled studies. In doing so, it aims to address three fundamental questions: What is the first-line treatment for GAD? How long should treatment continue? What is the best intervention in patients who do not respond to first-line and second-line treatments? Due to their efficacy in GAD and comorbid anxiety and depressive disorders, their tolerability and safety, certain selective serotonin re-uptake inhibitors (escitalopram, paroxetine, sertraline) should be considered the first-line treatment for most patients, although the serotonin-noradrenaline re-uptake inhibitor venlafaxine is a reasonable alternative. Little is known about the optimal length of therapy after response to acute treatment but relapse-prevention studies with paroxetine suggest that continuation treatment should last for at least 6 months. The management of patients who do not respond to first-line treatment is uncertain, but some patients may benefit from certain tricyclic antidepressants, buspirone, or pregabalin.
drug treatment, generalized anxiety disorder
1461-1457
293-302
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Polkinghorn, Claire
ce55ee4d-bce8-4573-af51-d384fdd513b0
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Polkinghorn, Claire
ce55ee4d-bce8-4573-af51-d384fdd513b0

Baldwin, David S. and Polkinghorn, Claire (2005) Evidence-based pharmacotherapy of Generalized Anxiety Disorder. International Journal of Neuropsychopharmacology, 8 (2), 293-302. (doi:10.1017/S1461145704004870).

Record type: Article

Abstract

Generalized Anxiety Disorder (GAD) is a common and often disabling disorder. This paper reviews the pharmacological treatment of GAD, based on the findings of published meta-analyses and randomized placebo-controlled studies. In doing so, it aims to address three fundamental questions: What is the first-line treatment for GAD? How long should treatment continue? What is the best intervention in patients who do not respond to first-line and second-line treatments? Due to their efficacy in GAD and comorbid anxiety and depressive disorders, their tolerability and safety, certain selective serotonin re-uptake inhibitors (escitalopram, paroxetine, sertraline) should be considered the first-line treatment for most patients, although the serotonin-noradrenaline re-uptake inhibitor venlafaxine is a reasonable alternative. Little is known about the optimal length of therapy after response to acute treatment but relapse-prevention studies with paroxetine suggest that continuation treatment should last for at least 6 months. The management of patients who do not respond to first-line treatment is uncertain, but some patients may benefit from certain tricyclic antidepressants, buspirone, or pregabalin.

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Published date: 2005
Keywords: drug treatment, generalized anxiety disorder

Identifiers

Local EPrints ID: 27526
URI: http://eprints.soton.ac.uk/id/eprint/27526
ISSN: 1461-1457
PURE UUID: 2b552d22-1bbd-4323-a330-d927e3ccf4f1

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Date deposited: 25 Apr 2006
Last modified: 04 Dec 2018 17:33

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