WCA Recommendations for the Long-Term Treatment of Generalized Anxiety Disorder

@article{Allgulander2003WCARF,
  title={WCA Recommendations for the Long-Term Treatment of Generalized Anxiety Disorder},
  author={Christer Allgulander and Borwin Bandelow and Eric Hollander and Stuart Montgomery and David J. Nutt and Ahmed Said Okasha and Mark H. Pollack and Dan J Stein and Richard P. Swinson},
  journal={CNS Spectrums},
  year={2003},
  volume={8},
  pages={53 - 61}
}
ABSTRACT What are the current recommendations for the long-term treatment of generalized anxiety disorder (GAD)? GAD is a common disorder with a lifetime prevalence of 4% to 7% in the general population. GAD is characterized by excessive, uncontrollable worry or anxiety about a number of events or activities that the individual experiences on more days than not over a 6-month period. Onset of GAD symptoms usually occurs during an individual's early twenties; however, high rates of GAD have also… 
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References

SHOWING 1-10 OF 71 REFERENCES
Long‐term pharmacological treatment of generalized anxiety disorder
TLDR
Only eight long‐term reports of studies conducted in well‐defined homogeneous groups of patients diagnosed with generalized anxiety disorder were found with the methodology of these studies presenting a number of limiting factors, and results are inconclusive and no reference drug could be identified.
The epidemiology of generalized anxiety disorder.
Generalized anxiety disorder. Longitudinal course and pharmacologic treatment.
  • E. Schweizer
  • Psychology
    The Psychiatric clinics of North America
  • 1995
Chronic anxiety: deciding the length of treatment.
TLDR
Establishing a secure and specific diagnosis and ruling out concomitant psychiatric and medical illnesses will augment the success of pharmacotherapy and nonpharmacologic techniques may well supplement medication trials.
Chronic anxiety: deciding the length of treatment.
TLDR
Based on these principles and on the available data, specific recommendations are given for treating patients with generalized anxiety disorder, panic disorder, social phobia, and obsessive compulsive disorder.
Psychological Treatment of Generalised Anxiety Disorder
TLDR
A balanced appraisal of the value of psychological therapy with this common condition requires a fuller description of sample characteristics and more systematic investigation of the clinical significance of treatment effects over the long term.
Efficacy, safety, and tolerability of venlafaxine XR in generalized anxiety disorder
  • J. Kelsey
  • Psychology
    Depression and anxiety
  • 2000
TLDR
Treatment with antidepressants, though associated with a longer onset of action than benzodiazepines, does not produce physiological dependency, and is useful in a patient population with a high prevalence of mood disorders.
Efficacy of venlafaxine extended-release capsules in nondepressed outpatients with generalized anxiety disorder: A 6-month randomized controlled trial.
TLDR
This first placebo-controlled demonstration of the long-term efficacy of any drug class in treating outpatients with DSM-IV-diagnosed GAD shows venlafaxine XR is an effective, rapidly acting, safe, once-daily agent for both the short- and long- term treatment of anxiety and may provide an important alternative to currently available anxiolytics.
Pharmacotherapy of generalized anxiety disorder.
  • J. Davidson
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 2001
TLDR
Treatment with antidepressants has opened up a new area of investigation into the pharmacotherapy of GAD, with a growing body of evidence supporting the role of therapies such as paroxetine and venlafaxine extended release.
...
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