From the Research
The most effective treatment for Generalized Anxiety Disorder (GAD) typically involves a combination of psychotherapy and medication, with selective serotonin reuptake inhibitors (SSRIs) such as duloxetine and escitalopram showing better efficacy, as evidenced by the most recent and highest quality study 1.
Treatment Options
- First-line medications include SSRIs such as sertraline (50-200 mg daily), escitalopram (10-20 mg daily), or paroxetine (20-50 mg daily), or serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (75-225 mg daily) or duloxetine (60-120 mg daily) 1.
- Cognitive-behavioral therapy (CBT) is the most effective psychotherapy approach, typically requiring 12-16 weekly sessions 2.
- Lifestyle modifications are also important, including regular exercise, adequate sleep, stress management techniques like mindfulness meditation, and avoiding caffeine and alcohol 2.
Medication Duration and Efficacy
- These medications usually take 2-4 weeks to show initial effects and should be continued for at least 6-12 months after symptom improvement 3, 2.
- Benzodiazepines like lorazepam may be used short-term for severe symptoms but aren't recommended long-term due to dependency risks 2.
Key Considerations
- The treatment of GAD should be individualized, taking into account the patient's comorbid conditions, drug dose ranges, and side effect profiles 2.
- Remission is attainable but can take several months, and stopping medication increases the risk of relapse within the first year of initiating treatment 2.
- The most recent and highest quality study 1 provides the best evidence for guiding treatment decisions, with duloxetine and escitalopram showing better efficacy.