Treatment of generalized anxiety disorder: A comprehensive review of the literature for psychopharmacologic alternatives to newer antidepressants and benzodiazepines

Primary Care Companion to the Journal of Clinical Psychiatry

Volumn 13, Issue 2, 2011, Pages

  Huh, John ^a   Goebert, Deborah ^a   Takeshita, Junji ^a   Lu, Brett Y ^a   Kang, Mark ^a  

^a UNIVERSITY OF HAWAII   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ALPRAZOLAM; ANTICONVULSIVE AGENT; ANTIDEPRESSANT AGENT; ARIPIPRAZOLE; BENZODIAZEPINE; BETAXOLOL; BROMAZEPAM; BUSPIRONE; DIAZEPAM; FLUOXETINE; GABAPENTIN; HYDROXYZINE; IMIPRAMINE; LORAZEPAM; NEUROLEPTIC AGENT; OLANZAPINE; ONDANSETRON; PAROXETINE; PLACEBO; PREGABALIN; PROPRANOLOL; QUETIAPINE; RILUZOLE; RISPERIDONE; TIAGABINE; TRAZODONE; UNINDEXED DRUG; VALPROIC ACID; VENLAFAXINE; ZIPRASIDONE;

AKATHISIA; AMYOTROPHIC LATERAL SCLEROSIS; ANTICHOLINERGIC EFFECT; ARTICLE; CLINICAL EFFECTIVENESS; CLINICAL GLOBAL IMPRESSION SCALE; COMBINATION CHEMOTHERAPY; CONSTIPATION; DEPRESSION; DIABETES MELLITUS; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; DIZZINESS; DOSAGE SCHEDULE COMPARISON; DOSE RESPONSE; DRUG COST; DRUG DOSE COMPARISON; DRUG DOSE INCREASE; DRUG DOSE TITRATION; DRUG EFFECT; DRUG EFFICACY; DRUG MECHANISM; DRUG MEGADOSE; DYSLIPIDEMIA; EXTRAPYRAMIDAL SYMPTOM; FATIGUE; GENERAL CONDITION DETERIORATION; GENERALIZED ANXIETY DISORDER; HAMILTON ANXIETY SCALE; HEADACHE; HEART MUSCLE CONDUCTION DISTURBANCE; HUMAN; LOW DRUG DOSE; MONOTHERAPY; NAUSEA; OPTIMAL DRUG DOSE; PANIC; PSYCHOPHARMACOTHERAPY; REMISSION; SEDATION; SIDE EFFECT; SOMNOLENCE; TARDIVE DYSKINESIA; WEIGHT GAIN;

EID: 79957748356     PISSN: 15235998     EISSN: 1555211X     Source Type: Journal    
DOI: 10.4088/PCC.08r00709     Document Type: Article

References (46)

1. Kessler RC, Chiu WT, Demler O, et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617-627. PubMed doi:10.1001/archpsyc.62.6.617
2. Wittchen HU, Kessler RC, Beesdo K, et al. Generalized anxiety and depression in primary care: prevalence, recognition, and management. J Clin Psychiatry. 2002;63(suppl 8):24-34. PubMed
3. Yonkers KA, Dyck IR, Warshaw M, et al. Factors predicting the clinical course of generalised anxiety disorder. Br J Psychiatry. 2000;176(6):544-549. PubMed doi:10.1192/bjp.176.6.544
4. Mogotsi M, Kaminer D, Stein DJ. Quality of life in the anxiety disorders. Harv Rev Psychiatry. 2000;8(6):273-282. PubMed
5. DuPont RL, Rice DP, Miller LS, et al. Economic costs of anxiety disorders. Anxiety. 1996;2(4):167-172. PubMed doi:10.1002/(SICI)1522-7154(1996)2:4<167::AID-ANXI2>3.0.CO;2-L
6. Greenberg PE, Sisitsky T, Kessler RC, et al. The economic burden of anxiety disorders in the 1990s. J Clin Psychiatry. 1999;60(7):427-435. PubMed doi:10.4088/JCP.v60n0702
7. Wittchen HU. Generalized anxiety disorder: prevalence, burden, and cost to society. Depress Anxiety. 2002;16(4):162-171. PubMed doi:10.1002/da.10065
8. Yonkers KA, Warshaw MG, Massion AO, et al. Phenomenology and course of generalised anxiety disorder. Br J Psychiatry. 1996;168(3):308-313. PubMed doi:10.1192/bjp.168.3.308
9. Baldwin DS, Anderson IM, Nutt DJ, et al; British Association for Psychopharmacology. Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2005;19(6):567-596. PubMed doi:10.1177/0269881105059253
10. Rickels K, Case WG, Schweizer E, et al. Long-term benzodiazepine users 3 years after participation in a discontinuation program. Am J Psychiatry. 1991;148(6):757-761. PubMed
11. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition. Washington, DC: American Psychiatric Association; 1980.
12. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Washington, DC: American Psychiatric Association; 1987.
13. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000.
14. Hoehn-Saric R, McLeod DR, Zimmerli WD. Differential effects of alprazolam and imipramine in generalized anxiety disorder: somatic versus psychic symptoms. J Clin Psychiatry. 1988;49(8):293-301. PubMed
15. McLeod DR, Hoehn-Saric R, Porges SW, et al. Effects of alprazolam and imipramine on parasympathetic cardiac control in patients with generalized anxiety disorder. Psychopharmacology (Berl). 1992;107(4):535-540. PubMed doi:10.1007/BF02245268
16. 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 Psychiatry. 1993;50(11):884-895. PubMed
17. Menza MA, Dobkin RD, Marin H. An open-label trial of aripiprazole augmentation for treatment-resistant generalized anxiety disorder. J Clin Psychopharmacol. 2007;27(2):207-210. PubMed doi:10.1097/01.jcp.0000248620.34541.bc
18. Hoge EA, Worthington JJ 3rd, Kaufman RE, et al. Aripiprazole as augmentation treatment of refractory generalized anxiety disorder and panic disorder. CNS Spectr. 2008;13(6):522-527. PubMed
19. Snyderman SH, Rynn MA, Rickels K. Open-label pilot study of ziprasidone for refractory generalized anxiety disorder. J Clin Psychopharmacol. 2005;25(5):497-499. PubMed doi:10.1097/01.jcp.0000177853.15910.de
20. Brawman-Mintzer O, Knapp RG, Nietert PJ. Adjunctive risperidone in generalized anxiety disorder: a double-blind, placebo-controlled study. J Clin Psychiatry. 2005;66(10):1321-1325. PubMed doi:10.4088/JCP.v66n1016
21. Simon NM, Hoge EA, Fischmann D, et al. An open-label trial of risperidone augmentation for refractory anxiety disorders. J Clin Psychiatry. 2006;67(3):381-385. PubMed doi:10.4088/JCP.v67n0307
22. Pollack MH, Simon NM, Zalta AK, et al. Olanzapine augmentation of fluoxetine for refractory generalized anxiety disorder: a placebo controlled study. Biol Psychiatry. 2006;59(3):211-215. PubMed doi:10.1016/j.biopsych.2005.07.005
23. Adson DE, Kushner MG, Eiben KM, et al. Preliminary experience with adjunctive quetiapine in patients receiving selective serotonin reuptake inhibitors. Depress Anxiety. 2004;19(2):121-126. PubMed doi:10.1002/da.10137
24. Simon NM, Connor KM, LeBeau RT, et al. Quetiapine augmentation of paroxetine CR for the treatment of refractory generalized anxiety disorder: preliminary findings. Psychopharmacology (Berl). 2008;197(4):675-681. PubMed doi:10.1007/s00213-008-1087-x
25. Katzman MA, Vermani M, Jacobs L, et al. Quetiapine as an adjunctive pharmacotherapy for the treatment of non-remitting generalized anxiety disorder: a flexible-dose, open-label pilot trial. J Anxiety Disord. 2008;22(8):1480-1486. PubMed oi:10.1016/j.janxdis.2008.03.002
26. Bandelow B, Chouinard G, Bobes J, et al. Extended-release quetiapine fumarate (quetiapine XR): a once-daily monotherapy effective in generalized anxiety disorder: data from a randomized, double-blind, placebo- and active-controlled study. Int J Neuropsychopharmacol. 2010;13(3):305-320. PubMed doi:10.1017/S1461145709990423
27. Swartz CM. Betaxolol in anxiety disorders. Ann Clin Psychiatry. 1998;10(1):9-14. PubMed doi:10.3109/10401239809148813
28. Darcis T, Ferreri M, Natens J, et al; The French GP Study Group for Hydroxyzine. A multicentre double-blind placebo-controlled study investigating the anxiolytic efficacy of hydroxyzine in patients with generalized anxiety. Hum Psychopharmacol. 1995;10(3):181-187. doi:10.1002/hup.470100303
29. Lader M, Scotto JC. A multicentre double-blind comparison of hydroxyzine, buspirone and placebo in patients with generalized anxiety disorder. Psychopharmacology (Berl). 1998;139(4):402-406. PubMed doi:10.1007/s002130050731
30. Llorca PM, Spadone C, Sol O, et al. Efficacy and safety of hydroxyzine in the treatment of generalized anxiety disorder: a 3-month double-blind study. J Clin Psychiatry. 2002;63(11):1020-1027. PubMed
31. Freeman AM 3rd, Westphal JR, Norris GT, et al. Efficacy of ondansetron in the treatment of generalized anxiety disorder. Depress Anxiety. 1997;5(3):140-141. PubMed doi:10.1002/(SICI)1520-6394(1997)5:3<140::AID-DA7>3.0.CO;2-I
32. Mathew SJ, Amiel JM, Coplan JD, et al. Open-label trial of riluzole in generalized anxiety disorder. Am J Psychiatry. 2005;162(12):2379-2381. PubMed doi:10.1176/appi.ajp.162.12.2379
33. Mathew SJ, Price RB, Mao X, et al. Hippocampal N-acetylaspartate concentration and response to riluzole in generalized anxiety disorder. Biol Psychiatry. 2008;63(9):891-898. PubMed doi:10.1016/j.biopsych.2007.09.012
34. Pollack MH, Matthews J, Scott EL. Gabapentin as a potential treatment for anxiety disorders. Am J Psychiatry. 1998;155(7):992-993. PubMed
35. Schaller JL, Thomas J, Rawlings D. Low-dose tiagabine effectiveness in anxiety disorders. MedGenMed. 2004;6(3):8. PubMed
36. Schwartz TL. The use of tiagabine augmentation for treatment-resistant anxiety disorders: a case series. Psychopharmacol Bull. 2002;36(2):53-57. PubMed
37. Crane D. Tiagabine for the treatment of anxiety. Depress Anxiety. 2003;18(1):51-52. PubMed doi:10.1002/da.10104
38. Schwartz TL, Azhar N, Husain J, et al. An open-label study of tiagabine as augmentation therapy for anxiety. Ann Clin Psychiatry. 2005;17(3):167-172. PubMed doi:10.1080/10401230591002138
39. Pollack MH, Tiller J, Xie F, et al. Tiagabine in adult patients with generalized anxiety disorder: results from 3 randomized, double-blind, placebo-controlled, parallel-group studies. J Clin Psychopharmacol. 2008;28(3):308-316. PubMed doi:10.1097/JCP.0b013e318172b45f
40. Pande AC, Crockatt JG, Feltner DE, et al. Pregabalin in generalized anxiety disorder: a placebo-controlled trial. Am J Psychiatry. 2003;160(3):533-540. PubMed doi:10.1176/appi.ajp.160.3.533
41. Feltner DE, Crockatt JG, Dubovsky SJ, et al. A randomized, double-blind, placebo-controlled, fixed-dose, multicenter study of pregabalin in patients with generalized anxiety disorder. J Clin Psychopharmacol. 2003;23(3):240-249. PubMed doi:10.1097/00004714-200306000-00005
42. Pohl RB, Feltner DE, Fieve RR, et al. Efficacy of pregabalin in the treatment of generalized anxiety disorder: double-blind, placebo-controlled comparison of BID versus TID dosing. J Clin Psychopharmacol. 2005;25(2):151-158. PubMed doi:10.1097/01.jcp.0000155820.74832.b0
43. Rickels K, Pollack MH, Feltner DE, et al. Pregabalin for treatment of generalized anxiety disorder: a 4-week, multicenter, double-blind, placebo-controlled trial of pregabalin and alprazolam. Arch Gen Psychiatry. 2005;62(9):1022-1030. PubMed doi:10.1001/archpsyc.62.9.1022
44. Montgomery SA, Tobias K, Zornberg GL, et al. Efficacy and safety of pregabalin in the treatment of generalized anxiety disorder: a 6-week, multicenter, randomized, double-blind, placebo-controlled comparison of pregabalin and venlafaxine. J Clin Psychiatry. 2006;67(5):771-782. PubMed doi:10.4088/JCP.v67n0511
45. Lydiard RB, Rickels K, Herman B, et al. Comparative efficacy of pregabalin and benzodiazepines in treating the psychic and somatic symptoms of generalized anxiety disorder. Int J Neuropsychopharmacol. 2010;13(2):229-241. PubMed doi:10.1017/S1461145709990460
46. Aliyev NA, Aliyev ZN. Valproate (depakine-chrono) in the acute treatment of outpatients with generalized anxiety disorder without psychiatric comorbidity: randomized, double-blind placebo-controlled study. Eur Psychiatry. 2008;23(2):109-114. PubMed doi:10.1016/j.eurpsy.2007.08.001