Abstract
The need for treatment of anxiety disorders is determined by the severity and persistence of symptoms, the presence of comorbid mental disorder or physical illness, the level of disability and impact on social functioning, concomitant medication, and a history of good response to, or poor tolerability of, previous treatment approaches. Choice of treatment is affected by the patients characteristics (such a previous response or contraindications), the evidence base supporting its use, patients and physicians preference, and the local availability of the respective intervention.
Severity, duration of illness and ongoing social adversity were associated with lack of improvement. There is good evidence for the efficacy of medication and cognitive behavioral therapy for anxiety disorders.
The physical activity and exercise have also positive effects in both clinical and nonclinical populations. Generalized anxiety disorder is amongst the most common mental disorders in primary care, leading to the disability comparable to that associated with major depression.
Systematic reviews and placebo-controlled RCTs indicate that some SSRIs, the SNRI venlafaxine, some benzodiazepines, imipramine, and buspirone are all efficacious in acute treatment; other compounds with proven efficacy include some antipsychotics, hydroxyzine, pregabalin, and agomelatin. Continuing with SSRI or SNRI treatment is associated with an increase in overall response rates in the long term studies.