title: An international survey of reported prescribing practice in the treatment of patients with generalised anxiety disorder.
abstract: OBJECTIVE
  To gain insight into the experience and practice of psychiatrists in the pharmacological management of patients with generalized anxiety disorder (GAD).
  
  
  METHODS
  Multiple-choice questionnaire completed by 501 psychiatrists (representing a 45% response rate) from 18 countries, selected by pharmaceutical company representatives to attend a scientific meeting, through having an interest in anxiety disorders.
  
  
  RESULTS
  Use of screening tools, routine structured diagnostic interviews, and practice guidelines was infrequent. Over one-third of patients did not receive their initial psychiatric consultation within a month after referral. A total of 45% of patients had symptoms for 2 years or longer before being diagnosed and treated. Most patients had been treated with benzodiazepines before referral. 80% of respondents always or often prescribed selective serotonin reuptake inhibitors (SSRIs), 43% serotonin-norepinephrine reuptake inhibitors (SNRIs), or pregabalin (35%) as first-line treatments. The most frequently recommended second-line treatments were SNRIs (41%) and pregabalin (36%). Concentration difficulties, fatigue, excessive worrying and pain were reported as the symptoms most difficult to manage.
  
  
  CONCLUSIONS
  Patients with GAD have frequently been treated with benzodiazepines before referral to a psychiatrist. SSRIs were the preferred first-line treatment, and SNRIs and pregabalin preferred second-line treatments. Reported practice in this sample appears largely consistent with recent evidence-based treatment guidelines.
authors: University of Southampton Faculty of Medicine, Southampton, UK. dsb1@soton.ac.uk
authors: David S
authors: DS
authors: Baldwin
authors: Christer
authors: C
authors: Allgulander
authors: Borwin
authors: B
authors: Bandelow
authors: Francisco
authors: F
authors: Ferre
authors: Stefano
authors: S
authors: Pallanti
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy*; D001569:Benzodiazepines / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D038622:Internationality; D007406:Interview, Psychological; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D000069583:Pregabalin; D012017:Referral and Consultation / Q000706:statistics & numerical data; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D001569:Benzodiazepines; D000069583:Pregabalin; D017367:Selective Serotonin Reuptake Inhibitors; D005680:gamma-Aminobutyric Acid