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Review

Treatments for generalized anxiety disorder

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Pages 285-294 | Published online: 10 Jan 2014

References

  • Kessler R, McGonagle K, Zhao S et al Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the national comorbidity survey. Amh. Gen. Bychiatry 51(1), 8–19 (1994).
  • Wittchen H, Zhao S, Kessler R, Eaton W DSM-III-R generalized anxiety disorder in the national comorbidity survey. Arch. Gen. Psychiatry51(5), 355–364 (1994).
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders OSM-10. Fourth Edition. American Psychiatric Association, Washington DC, USA (1994).
  • Kessler R, DuPont R, Berglund P, Wittchen H. Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys. Am. J. PFhiatry156(12), 1915-1923 (1999).
  • Should children take antidepressants? Harv. Ment. Health Lett. 20(6), 5–7 (2003).
  • Ballenger J. Clinical guidelines for establishing remission in patients with depression and anxiety. J. Gun. Psych. 60\(Suppl. 22), 29–34 (1999).
  • Di Nardo P, O'Brien G, Barlow D, Waddell M, Blanchard E. Reliability of DSM-III anxiety disorder categories using a new structured interview. Arch. Gen. Psychiatry 40(10), 1070–1074 (1983).
  • Rapee R. Generalized anxiety disorder: a review of clinical features and theoretical concepts. Clin. Psycho" Rev (11), 419–440 (1991).
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental DisordersThin] Edition.American Psychiatric Association, Washington DC, USA (1987).
  • Rickels K, DeMartinis N, Aufdembrinke B. A double-blind, placebo-controlled trial of abecarnil and diazepam in the treatment of patients with generalized anxiety disorder. .1. Clin. Bychopharmacol. 20(1), 12–18 (2000).
  • Salzman C, Miyawaki E, Le BP, Kerrihard T Neurobiologic basis of anxiety and its treatment. Harv. Rev PFhiatry1(4), 197–206 (1993).
  • Rickels K, Fox I, Greenblatt D, Sandler K, Schless A. Clorazepate and lorazepam: Clinical improvement and rebound anxiety. Am. fiychMtry145(3), 312–317 (1988).
  • Rickels K, Schweizer E, Csanalosi I et al Long-term treatment of anxiety and risk of withdrawal: prospective comparison of course and buspirone. Awl?. Gen. Psychiatry 45,444–450 (1988).
  • Rickels K, Schweizer E, De Martinis N, Mandos L, Mercer C. Gepirone and diazepam in generalized anxiety disorder: a placebo-controlled trial. j Clin. Psychopharmacol. 17(4), 272–277 (1997).
  • Shader R, Greenblatt D. Use of benzodiazepines in anxiety disorders. N Eng. Merl 328(19), 1398–1405 (1993).
  • Bertolino A, Mastucci E, Porro V et al. Etizolam in the treatment of generalized anxiety disorder: a controlled clinical trial. .1. Int. Med. Res. 17(5), 455–460 (1989).
  • Casacchia M, Bolino F, Ecari U. Etizolam in the treatment of generalized anxiety disorder: a double-blind study versus placebo. Curl: Med. Res. Opin. 12(4), 215–223 (1990).
  • Ross C, Matas M. A clinical trial of buspirone and diazepam in the treatment of generalized anxiety disorder. Can. J. PTchiatry 32 (5), 351–355 (1987) .
  • de Jonghe F, Swinkels J, Tuynman-Qua H, Jonkers E A comparative study of suriclone, lorazepam and placebo in anxiety disorder. Pharmacopsychiatry22(6), 266–271 (1989).
  • Hoehn-Saric R, McLeod D, Zimmerli W Differential effects of alprazolam and imipramine in generalized anxiety disorder: somatic versus psychic symptoms. J. Clin. Psych. 49,293–301 (1988).
  • Pourmotabbed T, Mcleod D, Hoehn-Saric R, Hipsley P, Greenblatt D. Treatment, discontinuation and psychomotor effects of diazepam in women with generalized anxiety disorder. J. Clin. Psychopharmacol. 16(3), 202–207 (1996).
  • Rocca P, Fonzo V, Scotta M, Zanalda E, Ravizza L. Paroxetine efficacy in the treatment of generalized anxiety disorder. Acta PTchiatr: Scam/. 95(5), 444–450 (1997).
  • Lydiard R, Laraia M, Ballenger J, Howell E. Emergence of depressive symptoms in patients receiving alprazolam for panic disorder. Am. J. Psychiatry 144(5), 664–665 (1987).
  • Rogers M, Warshaw M, Goisman R et al Comparing primary and secondary generalized anxiety disorder in a long-term naturalistic study of anxiety disorders. Depress. Anxiety 10(1), 1–7 (1999).
  • Mahe V, Balogh A. Long-term pharmacological treatment of generalized anxiety disorder. Int. Clin. Psychopharmacol. 15(2), 99–105 (2000).
  • Cutler N, Sramek J, Wardle T, Kurtz N, Kashkin K, Heller A. Double-blind, placebo-controlled, parallel-group comparison study of the efficacy and safety of ipsapirone and lorazepam in outpatients with generalized anxiety disorder. Biol. fiychiatry2, 901–904 (1991).
  • Ninan P. The functional anatomy, neurochemistry and pharmacology of anxiety. J. Clin. fiych. 60\(Suppl. 22), 12–17 (1999).
  • Schweizer E, Rickets K, Case W Greenblatt D. Long-term therapeutic use of benzodiazepines. Effects of gradual taper. Arch. Gen. Psychiatry 47(10), 908–915 (1990).
  • Laakmann G, Schule C, Lorkowski G, Baghai T, Kuhn K, Ehrentraut S. Buspirone and lorazepam in the treatment of generalized anxiety disorder in outpatients. fiychophatmacology136 (4), 357–366 (1998).
  • Sramek J, Frackiewicz E, Cutler N. Efficacy and safety of two dosing regimens of buspirone in the treatment of outpatients with persistent anxiety. Clin. Ther 19(3), 498–506 (1997).
  • Pollack M, Worthington J, Manfro G, Otto M, Zucker B. Abecarnil for the treatment of generalized anxiety disorder: a placebo-controlled comparison of two dosage ranges of abecarnil and buspirone. j Clin. fiychiatry58 (Suppl. 11), 19–23 (1997).
  • Feighner J. Buspirone in the long-term treatment of generalized anxiety disorder. J. Clin. Psych. 48(Suppl.), 3–6 (1987).
  • Pecknold J, Matas M, Howarth B et al Evaluation of buspirone as an antianxiety agent: buspirone and diazepam versus placebo. Can. J. Psychiatry 34 (8), 766–771 (1989).
  • Ansseau M, Olie J, von FR, Jourdain G, Stehle B, Guillet P. Controlled comparison of the efficacy and safety of four doses of suriclone, diazepam and placebo in generalized anxiety disorder. fiychophatmacology104 (4), 439–443 (1991).
  • Strand M, Hetta J, Rosen A et al A double- blind, controlled trial in primary care patients with generalized anxiety: a comparison between buspirone and oxazepam. j Clin. Psych. 51 (Suppl.), 40–45 (1990).
  • Enkelmann R. Alprazolam versus buspirone in the treatment of outpatients with generalized anxiety disorder. Psychopharmacology105,428–432 (1991).
  • Cutler N, Sramek J, Keppel HJ et al. A double-blind, placebo-controlled study comparing the efficacy and safety of ipsapirone versus lorazepam in patients with generalized anxiety disorder: a prospective multicenter trial. J. Clin. Psychopharmacol. 13(6), 429–437 (1993).
  • Cutler N, Hesselink J, Sramek J. A Phase II multicenter dose-finding, efficacy and safety trial of ipsapirone in outpatients with generalized anxiety disorder. Frog: Neumpsychophatmacol. Biol. fiych. 18(3), 447–463 (1994).
  • Boyer W, Feighner J. A placebo-controlled double-blind multicenter trial of two doses of ipsapirone versus diazepam in generalized anxiety disorder. Int. Clin. Psychopharmacol. 8(3), 173–176 (1993).
  • Rickels K, Schweizer E. The clinical presentation of generalized anxiety in primary-care settings: practical concepts of classification and management. J. Clin. Psych. 58\(Suppl. 11), 4–10 (1997).
  • Rickels K, De Martinis N, Garcia-Espana F, Greenblatt D, Mandos L, Rynn M. Imipramine and buspirone in treatment of patients with generalized anxiety disorder who are discontinuing long-term benzodiazepine therapy. Am. J. Psychiatry 157(12), 1973-1979 (2000).
  • Sussman N. The uses of buspirone in psychiatry. J. Clin. Psych. Monograph 12 (1), 3–19 (1994).
  • Feighner J. Overview of antidepressants currently used to treat anxiety disorders. J. Clin. Psych. 60\(Suppl. 22), 18–22 (1999).
  • Blackwell B. Adverse effects of antidepressant drugs. Part 1: monoamine oxidase inhibitors and tricyclics. Drugs 21(3), 201–219 (1981).
  • Andrews J, Nemeroff C. Contemporary management of depression. Am. J. Merl 97(6A), S24—S32 (1994).
  • Pollack M, Zaninelli R, Goddard A et al. Paroxetine in the treatment of generalized anxiety disorder: results of a placebo-controlled, flexible-dosage trial. j Clin. Psych. 62(5), 350–357 (2001).
  • Rickets K, Zaninelli R, McCafferty J, Bellew K, Iyengar M, Sheehan D. Paroxetine treatment of generalized anxiety disorder: a double-blind, placebo-controlled study. Am. BychMtry160(4), 749–756 (2003).
  • Stocchi F, Nordera G, Jokinen R et al Efficacy and tolerability of paroxetine for the long-term treatment of generalized anxiety disorder. J. Clin. Psych. 64(3), 250–258 (2003).
  • ••A long-term double-blind continuation trial of paroxetine, demonstrating clear efficacy of this drug on a key anxiety scale (Hamilton Rating Scale for Anxiety) and its domains and well as in everyday functioning. The work shows clear benefits with paroxetine in generalized anxiety disorder (GAD) therapy both in terms of response, remission and maintenance of significant treatment gains at eight months of therapy.
  • Connor K, Davidson J. Generalized anxiety disorder: neurobiological and pharmacotherapeutic perspectives. Biol. Psych. 44(12), 1286–1294 (1998).
  • Ressler K, Nemeroff C. Role of serotonergic and noradrenergic systems in the pathophysiology of depression and anxiety disorders. Depress. Anxiety12\(Suppl. 1), 2–19 (2000).
  • Cunningham L. Efficacy and tolerability of once daily venlafaxine extended release (XR) in outpatients with major depression and melancholia. j Clin. Psych. 56, 450–458 (1997).
  • Holliday S, Benneld P Venlafaxine. A review of its pharmacology and therapeutic potential in depression. Drugs 49(2), 280–294 (1995).
  • Thase M. Efficacy and tolerability of once- daily venlafaxine extended release (XR) in outpatients with major depression. The venlafaxine XR 209 study group. j Clin. Psych. 58(9), 393–398 (1997).
  • Hackett D, Parks V, Salinas E. Evaluation of 3 dose levels of venlafaxine extended-release in nondepressed outpatients with generalized anxiety disorder. Presented at the 151st American Psychiatric Association Annual Meeting; May 1998. Toronto, Canada, (1998).
  • Aguiar L, Haskins T, Rudolph R. Double- blind, placebo-controlled study of once-daily venlafaxine XR in outpatients with generalized anxiety disorder (GAD). Presented at the 151st American Psychiatric Association Annual Meeting May 1998. Toronto, Canada, (1998).
  • Gelenberg A, Lydiard R, Rudolph R, Aguiar L, Haskins J, Salinas E. Efficacy of venlafaxine extended-release capsules in nondepressed outpatients with generalized anxiety disorder: a 6-month randomized controlled trial. JAIVIA 283(23), 3082–3088 (2000). Demonstrates significant reductions in GAD symptomatology both with acute and long-term therapy (6 months) with venlafaxine extended -elease (XR). The results of this work point to higher response rates, higher remission and greater stability of response with venlafaxine XR treatment of GAD patients, and indicating that full benefits of therapy with venlafaxine XR are only attained with long-term therapy.
  • Davidson J, DuPont R, Hedges D, Haskins J. Efficacy, safety and tolerability of venlafaxine extended release and buspirone in outpatients with generalized anxiety disorder. j Clin. Psych. 60(8), 528–535 (1999).
  • Rickets K, Pollack M, Sheehan D, Haskins J. Efficacy of extended-release venlafaxine in nondepressed outpatients with generalized anxiety disorder. Am. j Psychiatry 157 (6), 968–974 (2000) .
  • Silverstone P, Salinas E. Efficacy of venlafaxine extended release in patients with major depressive disorder and comorbid generalized anxiety disorder. j Clin. Psych. 62(7), 523–529 (2001).
  • Sheehan DV Venlafaxine extended release (XR) in the treatment of generalized anxiety disorder. j Clin. Psych. 60\(Supp1. 22), 23–28 (1999).
  • Katz I, Reynolds C, Alexopoulos G, Hackett D. Venlafaxine XR as a treatment for generalized anxiety disorder in older adults: pooled analysis of five randomized placebo-controlled clinical trials. j Am. Ceriatr Soc. 50(1), 18–25 (2002).
  • Allgulander C, Hackett D, Salinas E. Venlafaxine extended release (ER) in the treatment of generalised anxiety disorder: 24-week placebo-controlled dose-ranging study. Br. fiych. 179,15-22 (2001).
  • Montgomery S, Sheehan D, Meoni P, Haudiquet V, Hackett D. Characterization of the longitudinal course of improvement in generalized anxiety disorder during long-term treatment with venlafaxine XR. Psychiatr. Res. 36(4), 209–217 (2002).
  • Ninan P. Dissolving the burden of generalized anxiety disorder. j Clin. Psych. 62 (Suppl. 19), 5–10 (2001).
  • Perugi G, Frare F, Toni C, Ruffolo G, Torti C. Open-label evaluation of venlafaxine sustained release in outpatients with generalized anxiety disorder with comorbid major depression or dysthymia: effectiveness, tolerability and predictors of response. Neumpsychobiology 46 (3), 145–149 (2002).
  • Effexor XR (venlafaxine hydrochloride) Product Monograph, Wyeth Laboratories, NJ, USA (2003).
  • Mayr B, Bonelli R. Severe headache with venlafaxine withdrawal. Ann. Pharmacother 37(7-8), 1145–1146 (2003).
  • Trenque TDP, Frances C, Millart H, Germain M. Reports of withdrawal syndrome with the use of SSRIs: a case/ noncase study in the french pharmacovigilance database. Pharmacoepiclemiol Drug Sal 11(4), 281–283 (2002).
  • Reeves R, Mack J, Beddingfield J. Shock- like sensations during venlafaxine withdrawal. Pharmacotherapy 23 (5), 678–681 (2003).
  • Haddad P. Antidepressant discontinuation syndromes. Drug- Sal 24 (3), 183–197 (2001).
  • Hedges D, Reimherr F, Strong R, Halls C, Rust C. An open trial of nefazodone in adult patients with generalized anxiety disorder. Psychopharmacol Bull. 32 (4), 671–676 (1996).
  • Rickels K, Downing R, Schweizer E et al Antidepressants for the treatment of generalized anxiety disorder: a placebo-controlled comparison of imipramine, trazodone and diazepam. Arch. Gen. Ptychiatry50,884 —895 (1993).
  • Zajecka J. The effect of nefazodone on comorbid anxiety symptoms associated with depression: experience in family practice and psychiatric outpatient settings. Clin. Psych. 57\(Suppl. 2), 10–14 (1996).
  • Spigset 0, Hagg S, Bate A. Hepatic injury and pancreatitis during treatment with serotonin reuptake inhibitors: data from the World Health Organization (WHO) database of adverse drug reactions. Int. Glitz Psychophatmacol 18(3), 157–161 (2003).
  • Barlow D, Rapee R, Brown T Behavioral treatment of generalized anxiety disorder. Behavior Ther 23,551–570 (1992).
  • Ost L, Breitholtz E. Applied relaxation vs. cognitive therapy in the treatment of generalized anxiety disorder. fkhav. Res. Ther 38(8), 777–790 (2000).
  • Borkovec T, Costello E. Efficacy of applied relaxation and cognitive—behavioral therapy in the treatment of generalized anxiety disorder. j Consult. Clin. Psycho" 61 (4), 611–619 (1993). An excellent dissection of the components of cognitive behavioural therapy that are specifically targeted at achieving effective gains in a variety of domains of GAD disability and impaired functioning. The work is a good approach to understanding the particular processes that facilitate improvements of psychotherapeutic interventions, lending support to the potential effectiveness of cognitive behavioural therapy in GAD as well as a number of alternative nonpharrnacologic approaches.
  • White J, Keenan M, Brooks N. Stress control: a controlled comparative investigation of large group therapy for generalized anxiety disorder. fkhav. Ptychothec 20,97–114 (1992).
  • Durham R, Murphy T, Allan T, Richard K, Treliving L, Fenton G. Cognitive therapy, analytic psychotherapy and anxiety management training for generalised anxiety disorder. BE j Psych. 165 (3), 315–323 (1994).
  • Butler G, Fennell M, Robson P, Gelder M. Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder. J Consult. Clin. Ptychol 59(1), 167–175 (1991).
  • Dugas M, Ladouceur R, Leger E et al Group cognitive—behavioral therapy for generalized anxiety disorder: treatment outcome and long-term follow-up. J. Consult. Clin. Ptychol 71(4), 821–825 (2003). Demonstrates the effectiveness of cognitive behavioural therapy in both the resolution of GAD symptomatology and the maintenance of symptom gains at two years follow up. In addition, the authors have been able to show that cognitive behavioural therapy can be achieved akin individual such therapy in a cost-effective small group setting. This study is a very good indicator of the potential efficacy of cognitive behavioural treatments methods in remission and relapse prevention carried out in a cost-effective manner.
  • Borkovec T, Newman M, Pincus A, Lytle R. A component analysis of cognitive—behavioral therapy for generalized anxiety disorder and the role of interpersonal problems. J Consult. Cita Psychol. 70(2), 288–298 (2002).
  • Amtz A. Cognitive therapy versus applied relaxation as treatment of generalized anxiety disorder. Behav. Res. Thec 41 (6), 633–646 (2003).
  • Wetherell J, Gatz M, Craske M. Treatment of generalized anxiety disorder in older adults. J Consult. Clin. Psychol. 71(1), 31–40 (2003).
  • Stanley M, Hopko D, Diefenbach G, Bourland S, Rodriguez H, Wagener Cognitive—behavior therapy for late-life generalized anxiety disorder in primary care: preliminary findings. Am J Ceriatc Psychiatry 11(1), 92–96 (2003).
  • Stanley M, Beck J, Novy D et al Cognitive—behavioral treatment of late-life generalized anxiety disorder. J Consult. Clin. Psychol. 71(2), 309–319 (2003).
  • Mohlman J, Gorenstein E, Kleber M, de JM, Gorman J, Papp L. Standard and enhanced cognitive—behavior therapy for late-life generalized anxiety disorder: two pilot investigations. Am. J Ceriatc Psych. 11(1), 24–32 (2003).
  • Durham R, Chambers J, MacDonald R, Power K, Major K Does cognitive—behavioural therapy influence the long-term outcome of generalized anxiety disorder? An 8–14 year follow-up of two clinical trials. Bychol Med 33(3), 499–509 (2003).
  • Kupfer D, Frank E. The interaction of drug and psychotherapy in the long-term treatment of depression. J Affect. Disond 62(1-2), 131–137 (2001).
  • Power K, Simpson R, Swanson V, Wallace L. A controlled study of cognitive—behaviour therapy, diazepam and placebo, alone and in combination for the treatment of generalised anxiety. J. Anxiety Dis. 4,267–292 (1990).
  • Bond A, Wingrove J, Valerie CH, Lader M. Treatment of generalised anxiety disorder with a short course of psychological therapy, combined with buspirone or placebo. J. Affect Dis. 72 (3), 267–271 (2002).
  • Lydiard R, Ballenger J, Rickels K. A double-blind evaluation of the safety and efficacy of abecarnil, alprazolam and placebo in outpatients with generalized anxiety disorder. Abecamil work group. J. Clin. Psych. 58\(Suppl. 11), 11–18 (1997).
  • Frattola L, Garreau M, Piolti R et al Comparison of the efficacy, safety and withdrawal of alpidem and alprazolam in anxious patients. BE J Psych. 165 (2), 94–100 (1994).
  • Ferreri M, Hantouche E. Recent clinical trials of hydroxyzine in generalized anxiety disorder. Acta Ptychiatc Stand. (Suppl. 393), 102–108 (1998).
  • Lader M, Scotto J. A multicentre double- blind comparison of hydroxyzine, buspirone and placebo in patients with generalized anxiety disorder. Psychopharmacology139(4), 402–406 (1998).
  • Llorca P, Spadone C, Sol 0 et al Efficacy and safety of hydroxyzine in the treatment of generalized anxiety disorder: a 3-month double-blind study. J Clin. Psych. 63 (11), 1020–1027 (2002).
  • Freeman A, Westphal J, Norris G et al Efficacy of ondansetron in the treatment of generalized anxiety disorder. Depress. Anxiety5(3), 140–141 (1997).
  • Moller H, Volz H, Reimann I, Stoll K. Opipramol for the treatment of generalized anxiety disorder: a placebo-controlled trial including an alprazolam-treated group. J. Clin. Psychopharmacol 21(1), 59–65 (2001).
  • Pande A, Crockatt J, Feltner D et al Pregabalin in generalized anxiety disorder: a placebo-controlled trial. Am. J Psych. 160(3), 533–540 (2003).

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