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Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review

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Strawn, Jeffrey R., Geracioti, Laura, Rajdev, Neil, Clemenza, Kelly, Levine, Amir·2018·Expert Opinion on Pharmacotherapy

DOI 10.1080/14656566.2018.1491966PMC PMC6340395

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Abstract

INTRODUCTION: Generalized anxiety disorder (GAD) often begins during adolescence or early adulthood and persists throughout the lifespan. Randomized controlled trials support the efficacy of selective serotonin and selective serotonin norepinephrine reuptake inhibitors (SSRIs and SNRIs, respectively), as well as benzodiazepines, azapirones, anti-adrenergic medications, melatonin analogs, second-generation antipsychotics, kava, and lavender oil in GAD. However, psychopharmacologic treatment selection requires clinicians to consider multiple factors, including age, co-morbidity, and prior treatment. Areas covered: The authors review the literature concerning pharmacotherapy for pediatric and adult patients with GAD with specific commentary on the efficacy and tolerability of selected agents in these age groups. The authors describe an algorithmic approach to the pediatric and adult patient with GAD and highlight considerations for the use of selected medications in these patients. Expert opinion: In adults with GAD, SSRIs and SNRIs represent the first-line psychopharmacologic treatment while second-line pharmacotherapies include buspirone, benzodiazepines, SGAs, and pregabalin. In pediatric patients with GAD, SSRIs should be considered the first line pharmacotherapy and psychotherapy enhances antidepressant response.

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Authors: Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A.
Affiliations: University of Cincinnati (US)
Columbia University (US)
Corresponding author: Strawn, Jeffrey R.
ORCID: Strawn, Jeffrey R.
Levine, Amir
Venue: Expert Opinion on Pharmacotherapy
Publisher: Informa UK Limited
Published: 2018-07-03
Volume: 19
Issue: 10
Pages: 1057-1070
ISSN: 1465-6566 (ISSN-L)
1744-7666
DOI: 10.1080/14656566.2018.1491966
PMC: PMC6340395
OpenAlex: W2884641336
Cited by: 214
References: 131
Citations by year: 2026: 18 · 2025: 27 · 2024: 38 · 2023: 50 · 2022: 33 · 2021: 23 · 2020: 21 · 2019: 2 · 2018: 2
FWCI: 1.91
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Expert Opinion on Pharmacotherapy (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (K23MH106037)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Health Sciences › Medicine › Complementary and alternative medicine › Medicinal Plant Extracts Effects
Keywords: generalized anxiety disorder, pharmacotherapy, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, benzodiazepines, buspirone, atypical antipsychotics, pregabalin, kava, lavender essential oil, childhood anxiety, adult anxiety, treatment selection algorithm, treatment efficacy and tolerability, psychotherapy
MeSH terms: Serotonin and Noradrenaline Reuptake Inhibitors, Adult, Antidepressive Agents, Anxiety Disorders, Child, Humans, Monoamine Oxidase Inhibitors, Antipsychotic Agents, Selective Serotonin Reuptake Inhibitors, Evidence-Based Practice

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Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review

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