Generalized anxiety disorder. Longitudinal course and pharmacologic treatment

GAD generally is a fairly prevalent disorder occurring at a rate (even in its "pure" form) that equals or exceeds the other anxiety disorders such as panic disorder and social phobia. GAD tends to have an early age of onset and tends to exhibit a high degree of chronicity that frequently is complicated by comorbidity with other anxiety disorders as well as by depression and other Axis I and II disorders. The pharmacologic treatment of GAD should be conceptualized from the first day of treatment in terms of the long-term nature of the illness, in much the same way that treatment of affective disorders is now conceptualized. And yet an enormous amount of research remains to be done, as we know very little from controlled studies about how to optimize maintenance treatment of this relatively neglected disorder.