title: Non-Antidepressant Treatment of Generalized Anxiety Disorder.
abstract: BACKGROUND
  Generalized anxiety disorder (GAD) is a prevalent and very disabling anxiety disorder. First-line medications are antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and noradrenalin reuptake inhibitors (SNRIs). However, a substantial number of patients do not reach remission while on antidepressants and they may develop troublesome side effects, which highlights the necessity of new therapeutic options for GAD.
  
  
  METHODS
  The purpose of this review is to discuss all non-antidepressant treatments studied in GAD. We searched MedLine for English articles published between 1980 and 2012, containing the following keywords: "generalized (or generalised) anxiety disorder" OR "anxiety disorder", AND "drug therapy" OR "herbal medicine". 76 articles were finally selected.
  
  
  RESULTS
  Pregabalin is the anticonvulsant with the most robust level of evidence in GAD. It rapidly reduces anxiety, has a safe side effect profile and presents a low potential for abuse. Among antipsychotics, quetiapine is the one of choice in GAD, with similar efficacy to SSRIs in low dosages, yet with lower overall tolerability. Benzodiazepines, buspirone and hydroxyzine are Food and Drugs administration (FDA) approved for GAD and have relatively good evidence of efficacy. Other drugs (betablockers, zolpidem, riluzole, etc.) and natural remedies (e.g. Piper methysticum) could be potential treatment options, yet additional research is warranted.
  
  
  CONCLUSIONS
  Pregabalin and quetiapine are the two most promising non-antidepressant treatments for GAD.
authors: Nada
authors: N
authors: Zahreddine
authors: Hôtel-Dieu de France University Hospital, Achrafieh, Lebanon.
authors: Sami
authors: S
authors: Richa
keywords: Anticonvulsants; antipsychotics; drug therapy; generalized anxiety; herbal treatment; pregabalin; quetiapine