title: Pharmacological treatment of generalized anxiety disorder.
abstract: BACKGROUND
  Generalized anxiety disorder (GAD) is a chronic, relapsing, debilitating disorder, associated with markedly impaired social and occupational functioning. Pharmacological treatment is considered standard care and several drug classes are now FDA approved for the treatment of GAD. While there are clear data for the efficacy of short-term acute treatment, long-term treatment and treatment-resistant GAD remain challenging.
  
  
  METHODS
  This article describes current pharmacological treatment options for GAD, with focus on benzodiazepines, azapirones, antidepressants and anticonvulsant and antipsychotic drugs. Recent findings from placebo-controlled clinical trials are reviewed and evidence-based clinical implications are discussed. A PubMed search was completed using the terms: 'generalized anxiety disorder AND treatment' and 'generalized anxiety disorder AND therapy'. Additional pivotal trials were included for a historical perspective (older landmark trials that established efficacy and safety for older drug classes in the treatment of GAD).
  
  
  CONCLUSIONS
  Efficacy for treatment of GAD has been established for several different drug classes. At present, based on clear efficacy and good tolerability, first-line treatment with either a selective serotonin reuptake inhibitor (SSRI) or a serotonin-norepinephrine reuptake inhibitor (SNRI) is indicated. If an initial, at least moderate, clinical response is achieved under antidepressant therapy, treatment should be at least continued for 12 months.
authors.affiliation: University of the Sciences, Philadelphia College of Pharmacy, Department of Pharmacy Practice/Pharmacy Administration, PA, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Reinhold
authors.forename: Laura A
authors.initials: LA
authors.lastname: Mandos
authors.forename: Karl
authors.initials: K
authors.lastname: Rickels
authors.forename: Falk W
authors.initials: FW
authors.lastname: Lohoff
mesh_terms: D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy*; D001569:Benzodiazepines / Q000627:therapeutic use; D002065:Buspirone / Q000627:therapeutic use; D002491:Central Nervous System Agents / Q000627:therapeutic use; D006801:Humans; D009638:Norepinephrine / Q000037:antagonists & inhibitors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D014151:Anti-Anxiety Agents; D001569:Benzodiazepines; D002065:Buspirone; D002491:Central Nervous System Agents; D009638:Norepinephrine; D017367:Selective Serotonin Reuptake Inhibitors