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Generalized Anxiety Disorder (GAD)

A condition marked by excessive worry and feelings of fear, dread, and uneasiness that last six months or longer.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Generalized Anxiety Disorder (GAD)

Everyone feels frightened or very scared every once in a while. When a threat approaches, such as a dangerous situation on the highway, fear can help to protect you. It puts the body in a state of readiness so that it can react to threats quickly. Worries and anxiety about the future, your job or family might also help to guard against danger. For example, by keeping you from making rash decisions that could lead to a precarious situation. But when these sorts of fears gain the upper hand, they can be a real burden. Some people end up constantly worrying about practically everything. If fears and anxiety are overshadowing everything else and not going away, it may be that the person has developed generalized anxiety disorder (GAD). Someone with generalized anxiety disorder usually realizes that their fears have become excessive, but they are not able to control them. It is a difficult position to get out of, but there are treatments that can help.

Symptoms

Generalized anxiety disorder can have both emotional and physical symptoms. The emotional symptoms include persistent, unrealistic and exaggerated fears that can affect different parts of someone's life. They are not a response to a threat and are not related to concrete things or situations. Because this feeling of anxiety can be associated with just about anything, it is referred to as "generalized" anxiety... Read more about Generalized Anxiety Disorder

What works? Research summarized

Evidence reviews

Valerian for anxiety disorders

Anxiety disorders are a very common mental health problem in the community. Most of the medications used to treat anxiety have side effects. Valerian is a phytotherapeutic medication frequently used for insomnia. The aim of this study was to investigate the efficacy and safety of valerian for anxiety disorders. Only one study was identified, involving 36 patients and comparing valerian with placebo and diazepam. This study found no significant differences in effectiveness between valerian and placebo, or between valerian and diazepam, for clinician‐rated anxiety symptoms, and that both valerian and diazepam were equally well tolerated by patients. However, additional studies with larger numbers of patients are necessary before drawing conclusions about the effectiveness and safety of valerian as a treatment option for anxiety disorders.

Second‐generation antipsychotic drugs for anxiety disorders 

Anxiety disorders are a prevalent and disabling condition. Because of high rates of treatment resistance, there is interest in new pharmacological treatment options such as second‐generation antipsychotics. This systematic review evaluated the efficacy and tolerability of second‐generation antipsychotics in the treatment of anxiety disorders. We found eleven randomised placebo‐controlled trials, comparing quetiapine, olanzapine and risperidone with placebo and antidepressants. The vast majority of the available data was on quetiapine (> 3000 participants). Participants with generalised anxiety disorder responded significantly better to quetiapine than to placebo, measured as a reduction in the Hamilton Anxiety Scale (HAM‐A). Participants treated with quetiapine were more likely to drop out due to adverse events, to gain weight, to suffer from sedation or to suffer from extrapyramidal side effects. The evidence on the other second‐generation antipsychotics is currently too limited to draw any conclusions.

Hydroxyzine for generalised anxiety disorder

Hydroxyzine is an anti‐histamine medication that has been studied in anxiety disorders. This review shows that hydroxyzine is better than placebo in terms of anxiety symptoms in individuals with generalised anxiety disorder (GAD). Too few data were available to be able to draw any conclusions about the efficacy and tolerability of hydroxyzine compared with benzodiazepines and buspirone. Given the robust evidence for the efficacy of antidepressants for GAD, these findings suggest that hydroxyzine should not be recommended as first‐line treatment GAD.

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Summaries for consumers

Valerian for anxiety disorders

Anxiety disorders are a very common mental health problem in the community. Most of the medications used to treat anxiety have side effects. Valerian is a phytotherapeutic medication frequently used for insomnia. The aim of this study was to investigate the efficacy and safety of valerian for anxiety disorders. Only one study was identified, involving 36 patients and comparing valerian with placebo and diazepam. This study found no significant differences in effectiveness between valerian and placebo, or between valerian and diazepam, for clinician‐rated anxiety symptoms, and that both valerian and diazepam were equally well tolerated by patients. However, additional studies with larger numbers of patients are necessary before drawing conclusions about the effectiveness and safety of valerian as a treatment option for anxiety disorders.

Second‐generation antipsychotic drugs for anxiety disorders 

Anxiety disorders are a prevalent and disabling condition. Because of high rates of treatment resistance, there is interest in new pharmacological treatment options such as second‐generation antipsychotics. This systematic review evaluated the efficacy and tolerability of second‐generation antipsychotics in the treatment of anxiety disorders. We found eleven randomised placebo‐controlled trials, comparing quetiapine, olanzapine and risperidone with placebo and antidepressants. The vast majority of the available data was on quetiapine (> 3000 participants). Participants with generalised anxiety disorder responded significantly better to quetiapine than to placebo, measured as a reduction in the Hamilton Anxiety Scale (HAM‐A). Participants treated with quetiapine were more likely to drop out due to adverse events, to gain weight, to suffer from sedation or to suffer from extrapyramidal side effects. The evidence on the other second‐generation antipsychotics is currently too limited to draw any conclusions.

Hydroxyzine for generalised anxiety disorder

Hydroxyzine is an anti‐histamine medication that has been studied in anxiety disorders. This review shows that hydroxyzine is better than placebo in terms of anxiety symptoms in individuals with generalised anxiety disorder (GAD). Too few data were available to be able to draw any conclusions about the efficacy and tolerability of hydroxyzine compared with benzodiazepines and buspirone. Given the robust evidence for the efficacy of antidepressants for GAD, these findings suggest that hydroxyzine should not be recommended as first‐line treatment GAD.

See all (19)

More about Generalized Anxiety Disorder

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Also called: Generalised anxiety disorder

Other terms to know:
Anxiety, Anxiety Disorders

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