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lüll Generalized anxiety disorder: acute and chronic treatment Rynn MA; Brawman-Mintzer OCNS Spectr 2004[Oct]; 9 (10): 716-23Clinical and epidemiological data suggest that generalized anxiety disorder (GAD) is a chronic illness causing patients to suffer for many years leading to significant distress in daily life functioning. The literature suggests the several conclusions. GAD is a disorder in need of appropriate treatment and often has a chronic course with comorbid conditions, such as major depression and other anxiety disorders. Benzodiazepines, while effective anxiolytic agents acutely, when prescribed for >4 weeks cause rebound anxiety and following prolonged therapy may lead to withdrawal symptoms. Antidepressants cause significant anxiety relief compared with placebo and for psychosocial treatment cognitive-behavioral therapy is an efficacious psychosocial treatment. Many GAD patients are in need of long-term medication management. Furthermore, there is limited data for patients diagnosed with GAD the treatment outcome with the combination of medication and psychotherapy both acutely and long-term; how to best sequence these treatments; for those patients who do not meet remission criteria what is the ideal approach for augmentation; and for patients with treatment-refractory GAD the empirical evidence is lacking on medication switching and augmentation strategies. Research is needed in the area of developing treatment strategies for patients suffering from treatment-refractory GAD. There is still an urgent need to explore treatment combinations and duration strategies in the management of patients suffering with GAD.|Acute Disease[MESH]|Anti-Anxiety Agents/*therapeutic use[MESH]|Anxiety Disorders/drug therapy/*therapy[MESH]|Chronic Disease[MESH]|Combined Modality Therapy[MESH]|Humans[MESH]|Psychotherapy/*methods[MESH]|Remission Induction[MESH]|Selective Serotonin Reuptake Inhibitors/*therapeutic use[MESH] |