First-line pharmacotherapy approaches for generalized anxiety disorder.

Published

Journal Article (Review)

Many patients with generalized anxiety disorder (GAD) do not receive adequate treatment. Several classes of drugs, including benzodiazepines, azapirones, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, antihistamines, alpha(2)delta Ca++ channel modulators, and atypical antipsychotics are consistently beneficial in patients with GAD. Cognitive therapy is also effective as a first-line treatment. When individualizing treatment, drug dose ranges and side effect profiles need to be considered, as well as the patient's comorbid conditions. Doses may need to be reduced for elderly or medically ill patients or those taking other medications. Doses may need to be increased for refractory cases. Common comorbid conditions with GAD include depression, alcohol or drug abuse, social anxiety disorder, and panic disorder. In patients with significant depression, an antidepressant is more likely to succeed than a benzodiazepine. Generalized anxiety disorder is a chronic illness that requires long-term treatment. Remission is attainable but can take several months, and stopping medication increases the risk of relapse within the first year of initiating treatment.

Full Text

Duke Authors

Cited Authors

  • Davidson, JR

Published Date

  • January 2009

Published In

Volume / Issue

  • 70 Suppl 2 /

Start / End Page

  • 25 - 31

PubMed ID

  • 19371504

Pubmed Central ID

  • 19371504

Electronic International Standard Serial Number (EISSN)

  • 1555-2101

International Standard Serial Number (ISSN)

  • 0160-6689

Language

  • eng