Table 1.

Advantages and Disadvantages of Currently Available Treatment Options for Generalized Anxiety Disorder (GAD)

Type of Treatment	Advantages	Disadvantages
Benzodiazepines	Have been widely used in GAD	Problematic side effects, including drowsiness and confusion
	Can reduce psychic and somatic symptoms	Risk of dependence and discontinuation symptoms
	Rapid onset of action	Abuse potential
	Role in acute management	Ineffective against depression
Azapirones	Some efficacy in GAD	Limited efficacy
	Not associated with risk of dependency	Slow onset of action
		Variable tolerability, including risk of sedation and nausea
		Perceived as ineffective against comorbid conditions
Tricyclic/atypical antidepressants	Possible role as second-line therapy in GAD	Slow onset of action
	Sedating tricyclics can be useful in presence of insomnia	Poor tolerance
	Not associated with risk of dependency
SSRIs/SNRIs	Recommended first-line treatments in GAD	Slow onset of action
	Effective against comorbid depression	Sexual dysfunction and other side effects limit compliance
		Tolerability/withdrawal issues
Antihistamines	Have been widely used in GAD	Slow onset of action
	Not associated with risk of dependency	Lack of demonstrated efficacy against comorbid disorders
		Sedation and anticholinergic effects
α2δ ligands	Effective for psychic and somatic symptoms of GAD	Not indicated for depression
	Rapid onset of action	Somnolence, dizziness
	Low potential for withdrawal effects	Weight gain
	Low incidence of drug-drug interactions	Low abuse potential
Antipsychotics	Effective for symptoms of GAD	Data currently unpublished
		Metabolic side effects
Psychological therapies	Some psychological approaches demonstrated to be effective, such as cognitive-behavioral therapy	Not all psychological therapies have demonstrated efficacy in clinical trials
	Can avoid need for pharmacotherapy	Some patients reluctant to undergo psychological therapy
		Limited availability of trained therapists can restrict service provision

Abbreviations: CBT = cognitive-behavioral therapy, SNRI = serotonin-norepinephrine reuptake inhibitor, SSRI = selective serotonin reuptake inhibitor.