The article you requested is
Pharmacotherapy of Generalized Anxiety Disorder
J Clin Psychiatry 2002;63(suppl 14):9-16
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Less than one third of people afflicted with generalized anxiety disorder (GAD) experience spontaneous
remission, and the symptoms of GAD wax and wane throughout a person’s life. The burden of
GAD may be reduced with psychopharmacologic therapy. The medications with the most evidence of
efficacy in GAD are the benzodiazepines, including a new long-acting formulation of alprazolam.
These drugs have a low incidence of side effects but may cause physical dependence, withdrawal, and
sedation. Antidepressants are also efficacious in GAD but act less quickly than benzodiazepines. Tricyclic
antidepressants such as imipramine may substantially reduce symptoms of anxiety but are not
considered a first-line therapy because of their side effects spectrum. The extended-release formulation
of venlafaxine and selective serotonin reuptake inhibitors such as paroxetine and sertraline are
also efficacious in GAD. While their association with sexual dysfunction may be intolerable for some
adults, these drugs may be more appropriate than the benzodiazepines because their chronic use does
not lead to dependence. Buspirone also significantly reduces symptoms of GAD and is associated
with less sexual dysfunction than SSRIs and less sedation than benzodiazepines. Combining antidepressant
and benzodiazepine therapy or medication treatment and psychotherapy may lead to an increase
in improvement in patients not responding to 1 treatment approach alone. The most effective
treatment for managing the recurrent symptoms of this chronic disorder will remain unknown until
more long-term studies using both drug and nondrug therapies are conducted. Remission rates are still
only about 40%, signifying the need for improved treatment interventions.