title: The diagnosis and treatment of generalized anxiety disorder.
abstract: BACKGROUND
  Generalized anxiety disorder (GAD) is a common and serious disease with a lifetime prevalence of 4.3% to 5.9%. It is underdiagnosed in primary care.
  
  
  METHODS
  Recommendations on the treatment of GAD are given on the basis of all available findings from pertinent randomized trials, retrieved by a selective search of the literature.
  
  
  RESULTS
  Among psychotherapeutic techniques, various kinds of cognitive behavioral therapy (CBT) have been found useful in controlled trials. The drugs of first choice include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephine reuptake inhibitors (SNRIs), and the calcium-channel modulator pregabalin. Tricyclic antidepressants are also effective but have more adverse effects than SSRIs. Although benzodiazepines are effective anxiolytic agents for short-term use, they should not be given over the long term because of the danger of addiction. Buspirone, an azapirone, was found to be effective in a small number of trials, but the findings across trials are inconsistent. The response rate of GAD to CBT in published studies lies between 47% and 75%, while its response rate to drug treatment lies between 44% and 81%.
  
  
  CONCLUSIONS
  The treatment of GAD with CBT and drugs is evidence-based and has a good chance of improving the manifestations of the disorder.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany. Sekretariat.Bandelow@med.uni-goettingen.de
authors.forename: Borwin
authors.initials: B
authors.lastname: Bandelow
authors.forename: Reinhard
authors.initials: R
authors.lastname: Boerner J
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
authors.forename: Michael
authors.initials: M
authors.lastname: Linden
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
mesh_terms: D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000628:therapy*; D001569:Benzodiazepines / Q000627:therapeutic use*; D002065:Buspirone / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D001569:Benzodiazepines; D002065:Buspirone