Encyclopedia of Psychopharmacology

2015 Edition
| Editors: Ian P. Stolerman, Lawrence H. Price

Generalized Anxiety Disorder

  • Malcolm LaderEmail author
Reference work entry
DOI: https://doi.org/10.1007/978-3-642-36172-2_317


Anxiety neurosis; Free-floating anxiety; GAD


Generalized anxiety disorder (GAD) is characterized by an excessive and inappropriate worrying that is persistent and not restricted to particular circumstances. Patients have physical anxiety symptoms (such as tachycardia and tremor) and key psychological symptoms, including restlessness, fatigue, difficulty in concentrating, irritability, and disturbed sleep. The disorder is common and disabling; a recent review of epidemiological studies in Europe suggests a 12-month prevalence of between 1.7 % and 3.75 % (being more common in old age), and the associated functional impairment is similar to that with major depression. However, many of those who might benefit from treatment are not recognized or treated, which is disappointing, as a broad range of evidence-based treatments is available.

Role of Pharmacotherapy

Efficacy in Acute Treatment

Current evidence-based guidelines for the pharmacological management of patients...

This is a preview of subscription content, log in to check access.


  1. Baldwin DS (2008) Room for improvement in the pharmacological treatment of anxiety disorders. Curr Pharm Des 14:3482–3491CrossRefPubMedGoogle Scholar
  2. Baldwin DS, Ajel K (2007) The role of pregabalin in the treatment of generalized anxiety disorder. Neuropsychiatr Dis Treat 3:185–191CrossRefPubMedCentralPubMedGoogle Scholar
  3. Baldwin DS, Anderson IM, Nutt DJ et al (2005) Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British association for psychopharmacology. J Psychopharmacol 19:567–596CrossRefPubMedGoogle Scholar
  4. Baldwin DS, Montgomery SA, Nil R et al (2007) Discontinuation symptoms in depression and anxiety disorders. Int J Neuropsychopharmacol 10:73–84CrossRefPubMedGoogle Scholar
  5. Baldwin DS, Schweitzer E, Lu Y, Lyndon G (2012) Does early improvement predict end-point response in patients with generalized anxiety disorder? Eur Neuropsychopharmacol 22:137–142CrossRefPubMedGoogle Scholar
  6. Baldwin DS, Stein DJ, Dolberg OT, Bandelow B (2009) How long should a trial of escitalopram treatment be in patients with major depressive disorder, generalised anxiety disorder or social anxiety disorder? An exploration of the randomised controlled trial database. Hum Psychopharmacol 24:269–275CrossRefPubMedGoogle Scholar
  7. Baldwin DS, Woods R, Lawson TD (2011) Efficacy of treatments for generalized anxiety disorder: systematic review and meta-analysis. BMJ 342:d1199CrossRefPubMedGoogle Scholar
  8. Bandelow B, Seidler-Brandler U, Becker A et al (2007) Meta-analysis of randomized controlled comparisons of psychopharmacological and psychological treatments for anxiety disorders. World J Biol Psychiatr 8:175–187CrossRefGoogle Scholar
  9. Bandelow B, Zohar J, Hollander E et al (2008) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders – first revision. World J Biol Psychiatry 9:248–312CrossRefPubMedGoogle Scholar
  10. Chessick CA, Allen MH, Thase M et al (2006) Azapirones for generalized anxiety disorder. Cochrane Database Syst Rev 3, CD006115PubMedGoogle Scholar
  11. Hidalgo RB, Tupler LA, Davidson JRT (2007) An effect-size analysis of pharmacologic treatments for generalized anxiety disorder. J Psychopharmacol 21:864–872CrossRefPubMedGoogle Scholar
  12. Pollack MH, Kornstein SG, Spann ME, Crits-Christoph P, Raskin J, Russell JM (2008) Early improvement during duloxetine treatment of generalized anxiety disorder predicts response and remission at endpoint. J Psychiatr Res 42:1176–1184CrossRefPubMedGoogle Scholar
  13. Rickels K, Shivitz TM, Ramey TS, Weaver JJ, Knapp LR, Miceli JJ (2012) Adjunctive therapy with pregabalin in generalized anxiety disorder patients with partial response to SSRI or SNRI treatment. Int Clin Psychipharmacol 27:142–150CrossRefGoogle Scholar
  14. Stein MB, Schork NJ, Gelernter J (2008) Gene-by-environment (serotonin transporter and childhood maltreatment) interaction for anxiety sensitivity, an intermediate phenotype for anxiety disorders. Neuropsychopharmacology 33:312–319CrossRefPubMedGoogle Scholar
  15. Tyrer P, Baldwin DS (2006) Generalised anxiety disorder. Lancet 368:2156–2166CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK