Pharmacological treatment of generalized anxiety disorder

被引:71
作者
Reinhold, Jennifer A. [2 ]
Mandos, Laura A. [2 ]
Rickels, Karl [1 ]
Lohoff, Falk W. [1 ]
机构
[1] Univ Penn, Sch Med, Dept Psychiat, Ctr Neurobiol & Behav,Translat Res Labs, Philadelphia, PA 19104 USA
[2] Univ Sci, Philadelphia Coll Pharm, Dept Pharm Practice, Pharm Adm, Philadelphia, PA USA
关键词
antidepressants; anxiety; efficacy; evidence-based treatment; pharmacotherapy; relapse; safety; tolerability; treatment response; SEROTONIN REUPTAKE INHIBITORS; VENLAFAXINE EXTENDED-RELEASE; MAJOR DEPRESSIVE DISORDER; DOUBLE-BLIND; ADULT PATIENTS; OPEN-LABEL; ARIPIPRAZOLE AUGMENTATION; ATYPICAL ANTIPSYCHOTICS; ADJUNCTIVE RISPERIDONE; DULOXETINE TREATMENT;
D O I
10.1517/14656566.2011.618496
中图分类号
R9 [药学];
学科分类号
100702 [药剂学];
摘要
Introduction: Generalized anxiety disorder (GAD) is a chronic, relapsing, debilitating disorder, associated with markedly impaired social and occupational functioning. Pharmacological treatment is considered standard care and several drug classes are now FDA approved for the treatment of GAD. While there are clear data for the efficacy of short-term acute treatment, long-term treatment and treatment-resistant GAD remain challenging. Areas covered: This article describes current pharmacological treatment options for GAD, with focus on benzodiazepines, azapirones, antidepressants and anticonvulsant and antipsychotic drugs. Recent findings from placebo-controlled clinical trials are reviewed and evidence-based clinical implications are discussed. A PubMed search was completed using the terms: 'generalized anxiety disorder AND treatment' and 'generalized anxiety disorder AND therapy'. Additional pivotal trials were included for a historical perspective (older landmark trials that established efficacy and safety for older drug classes in the treatment of GAD). Expert opinion: Efficacy for treatment of GAD has been established for several different drug classes. At present, based on clear efficacy and good tolerability, first-line treatment with either a selective serotonin reuptake inhibitor (SSRI) or a serotonin-norepinephrine reuptake inhibitor (SNRI) is indicated. If an initial, at least moderate, clinical response is achieved under antidepressant therapy, treatment should be at least continued for 12 months.
引用
收藏
页码:2457 / 2467
页数:11
相关论文
共 84 条
[1]
Treatment of residual anxiety symptoms with adjunctive aripiprazole in depressed patients taking selective serotonin reuptake inhibitors [J].
Adson, DE ;
Kushner, MG ;
Fahnhorst, TA .
JOURNAL OF AFFECTIVE DISORDERS, 2005, 86 (01) :99-104
[2]
Valproate (depakine-chrono) in the acute treatment of outpatients with generalized anxiety disorder without psychiatric comorbidity: Randomized, double-blind placebo-controlled study [J].
Aliyev, Nadir A. ;
Aliyev, Zafar N. .
EUROPEAN PSYCHIATRY, 2008, 23 (02) :109-114
[3]
A non-inferiority comparison of duloxetine and venlafaxine in the treatment of adult patients with generalized anxiety disorder [J].
Allgulander, C. ;
Nutt, D. ;
Detke, M. ;
Erickson, J. ;
Spann, M. ;
Walker, D. ;
Ball, S. G. ;
Russell, J. M. .
JOURNAL OF PSYCHOPHARMACOLOGY, 2008, 22 (04) :417-425
[4]
Prevention of relapse in generalized anxiety disorder by escitalopram treatment [J].
Allgulander, Christer ;
Florea, Ioana ;
Huusom, Anna K. Trap .
INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY, 2006, 9 (05) :495-505
[5]
Allgulander Christer, 2002, Psychopharmacol Bull, V36 Suppl 2, P79
[6]
Novel approaches to treatment of generalized anxiety disorder [J].
Allgulander, Christer .
CURRENT OPINION IN PSYCHIATRY, 2010, 23 (01) :37-42
[7]
Generalized Anxiety Disorder: Between Now and DSM-V [J].
Allgulander, Christer .
PSYCHIATRIC CLINICS OF NORTH AMERICA, 2009, 32 (03) :611-+
[8]
Duration of untreated illness as a predictor of treatment response and clinical course in generalized anxiety disorder [J].
Altamura, A. Carlo ;
Dell'Osso, Bernardo ;
D'Urso, Nazario ;
Russo, Michela ;
Fumagalli, Sara ;
Mundo, Emanuela .
CNS SPECTRUMS, 2008, 13 (05) :415-422
[9]
Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology [J].
Baldwin, DS ;
Anderson, IM ;
Nutt, DJ ;
Bandelow, B ;
Bond, A ;
Davidson, JRT ;
den Boer, JA ;
Fineberg, NA ;
Knapp, M ;
Scott, J ;
Wittchen, HU .
JOURNAL OF PSYCHOPHARMACOLOGY, 2005, 19 (06) :567-596
[10]
Remission rates in patients with anxiety disorders treated with paroxetine [J].
Ballenger, JC .
JOURNAL OF CLINICAL PSYCHIATRY, 2004, 65 (12) :1696-1707