Neuropsi

Journal of Psychopharmacology
http://jop.sagepub.com Review: A psychopharmacological treatment algorithm for generalised anxiety disorder (GAD)
JR Davidson, W. Zhang, KM Connor, J. Ji, K. Jobson, Y. Lecrubier, AC McFarlane, DJ Newport, DJ Nutt, DN Osser, DJ Stein, ZN Stowe, O. Tajima and M. Versiani J Psychopharmacol 2010; 24; 3 originally published online Oct 2, 2008; DOI:10.1177/0269881108096505 The online version of this article can be found at: http://jop.sagepub.com/cgi/content/abstract/24/1/3

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Review

A psychopharmacological treatment algorithm for generalised anxiety disorder (GAD)

Journal of Psychopharmacology24(1) (2010) 3–26 © 2010 British Association for Psychopharmacology ISSN 0269-8811 SAGE Publications Ltd, Los Angeles, London, New Delhi and Singapore 10.1177/0269881108096505

JR Davidson Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. W Zhang Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. KMConnor Clinical Neuroscience and Ophthalmology, Merck Research Laboratories, Merck & Co., Inc., North Wales, PA , USA. J Ji Department of Mental Health, Shanghai Medical School, Fudan University; Department of Psychological Medicine, Zhongshan Hospital, Shanghai, China. K Jobson Department of Psychiatry, University of Tennessee, Knoxville, TN , USA. Y Lecrubier European College ofNeuropsychopharmacology, Hôpital La Salpetriere, Paris, France. AC McFarlane The University of Adelaide, Centre for Military and Veterans’ Health, Adelaide, SA, Australia. DJ Newport Women’s Mental Health Program, Emory University School of Medicine, Atlanta, GA, USA. DJ Nutt Psychopharmacology Unit, Department of Community-based Medicine, University of Bristol, Bristol , UK. DN Osser Department of Psychiatry,Harvard Medical School, VA Boston Healthcare System, Brockton, MA, USA. DJ Stein Department of Psychiatry and Mental Health, University of Capetown, Cape Town, South Africa. ZN Stowe Women’s Mental Health Program, Emory University School of Medicine, Atlanta, GA, USA. O Tajima Department of Mental Health, Kyorin University, School of Health Sciences, Tokyo, Japan. M Versiani Institute of Psychiatry,Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Abstract
Generalised anxiety disorder (GAD) is defined as excessive and uncontrollable worry and anxiety about everyday life situations. It is a chronic disorder, and is associated with substantial somatisation, high rates of comorbid depression and other anxiety disorders, and significant disability. The evidence base forpharmacotherapy and psychotherapy has continued to grow, and a wide range of drug choices for GAD now exists. Current guidelines for GAD generally restrict themselves to presentation of the evidence for various treatments, which, as a result, generally do not offer detailed discussion or recommendation of strategies beyond the first level of treatment, or take into account the individual circumstances of thepatient. Thus, there is a lack of algorithm-based treatment guidelines for GAD. Our aim is, therefore, to present an algorithm for the psychopharmacologic management of GAD, intended for all clinicians who treat patients with GAD, where issues of pharmacotherapy are under consideration. We also hope that these GAD algorithms and other guidelines can help to identify high-priority areas that need...