Cited by 128Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major DepressionPsychological Treatments and Disorders

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Current Considerations in the Treatment of Generalized Anxiety Disorder

Katzman, Martin A.·2009·CNS Drugs

DOI 10.2165/00023210-200923020-00002

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Abstract

Generalized anxiety disorder (GAD) is a chronic disorder that frequently co-occurs with a variety of co-morbidities in patients with somatic conditions and other mental disorders. GAD is highly prevalent and is one of the most common anxiety disorders seen by primary care physicians. The individual and societal cost associated with GAD is high and the marked level of impairment experienced by patients with this disorder is equivalent in magnitude to that reported in patients with major depressive disorder. Furthermore, patients with GAD are at risk of suicide or suicide attempts, and are frequent users of healthcare services. Thus, GAD is a serious and chronic condition that requires appropriate long-term treatment. The focus of acute treatment for patients with GAD is the improvement of symptoms, while the primary goal of long-term clinical management is remission, i.e. the complete resolution of both symptoms and functional impairment. The consensus across current treatment guidelines is that first-line treatment for patients with GAD should consist of an antidepressant, either a selective serotonin reuptake inhibitor (SSRI) such as sertraline, paroxetine or escitalopram, or a selective serotonin noradrenaline (norepinephrine) reuptake inhibitor (SNRI) such as venlafaxine or duloxetine. However, the SSRIs and SNRIs have efficacy limitations, such as lack of response in many patients, a 2- to 4-week delay before the onset of symptom relief, lack of full remission, and risk of relapse. In addition, there are troublesome adverse effects associated with both the SSRIs and SNRIs. Evidence from early clinical studies of the atypical antipsychotics in the treatment of anxiety and GAD indicate that they may have a potential role in the treatment of GAD, either as monotherapy or as augmentation to standard treatment.

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Authors: Katzman, M. A.
Affiliations: START Clinic (CA)
Corresponding author: Katzman, Martin A.
ORCID: Katzman, Martin A.
Venue: CNS Drugs
Publisher: Springer Science and Business Media LLC
Published: 2009
Volume: 23
Issue: 2
Pages: 103-120
ISSN: 1172-7047 (ISSN-L)
DOI: 10.2165/00023210-200923020-00002
OpenAlex: W2067903360
Cited by: 128
References: 140
Citations by year: 2026: 4 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 10 · 2021: 4 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 7 · 2015: 9 · 2014: 12 · 2013: 11 · 2012: 16
FWCI: 2.15
Type: journal article
Language: en
Open access: closed
Locations: CNS Drugs (publishedVersion)
PubMed (publishedVersion)
Funders: AstraZeneca
H. Lundbeck A/S
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
Keywords: generalized anxiety disorder, antidepressants, selective serotonin reuptake inhibitors, atypical antipsychotics, augmentation therapy, remission, relapse, adverse drug reactions, comorbidities, primary care, treatment guidelines
MeSH terms: Anxiety Disorders, Clinical Trials as Topic, Drug Resistance, Humans, Psychotherapy, Antipsychotic Agents, Selective Serotonin Reuptake Inhibitors, Practice Guidelines as Topic, Adrenergic Uptake Inhibitors

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