Pharmacotherapy of generalized anxiety disorder

Benzodiazepines have traditionally been used to treat acute anxiety disorders, but they are not ideal in the treatment of chronic generalized anxiety disorder (GAD). Following long-term therapy, benzodiazepines have the potential to produce dependency and withdrawal symptoms. In addition, although agents such as the benzodiazepines and buspirone alleviate anxiety, they have little effect on depression, which is a common comorbidity of GAD. Antidepressants have long been viewed as promising alternatives to benzodiazepines for the treatment of some types of anxiety. Although they have been shown to be useful in the treatment of panic disorder, social anxiety disorder/social phobia, and obsessive-compulsive disorder, they have not until recently been regarded as potential therapies for GAD. 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.