Treatment for Generalized Anxiety Disorder

    Published: 06-16-2009
    Views: 18,969
    Psychologist Douglas Mennin, PhD, talks about treatment options available for people who are diagnosed with GAD. Psychiatrist Beth Salcedo, MD, describes medications used to treat anxiety disorders.

    Dr. Douglas Mennin: Hello! I'm Dr. Douglas Mennin, psychologist and a professional member of the Anxiety Disorders Association of America. Today, we're discussing stress and anxiety, and now I want to talk about treatment options available for people who are diagnosed with GAD.

    Most people who seek treatment for GAD and other anxiety orders find significant improvement and enjoy a better quality of life. A variety of treatment options exists, including cognitive-behavioral therapy, exposure therapy, and medications. Relaxation techniques, meditation, yoga, exercise, and other alternative treatments may also become part of the treatment plan.

    A doctor may recommend one or a combination of these. No one treatment is right for every person. A little treatment is individualized, standard approaches have proved effective. Cognitive-behavioral therapy is a well-established, highly effective, and lasting treatment. It helps people to identify, understand, and modify faulty thinking and behavior patterns. It enables people with GAD to learn to control their worry, often within 12 to 16 weeks. Other forms of therapy are also effective, and your doctor will determine what's appropriate for you.

    Dr. Beth Salcedo: Medication treatment is generally safe and effective for anxiety, and we often use it in conjunction with therapy. Medication can be a short-term or a long-term treatment option. This choice depends on how severe symptoms are, other medical conditions, and individual circumstances. It often takes time and patience to find the drug that works best for you.

    Some medications are fast-acting, and we prescribe them for short-term use. Others require several weeks to become effective. Each drug presents benefits and possible side effects. So it's important to discuss these with your doctor. Common side effects may include headache, nausea, sleeplessness, drowsiness, weight gain, flat feeling, or reduced interest in sex.

    Never stop taking your prescription on your own, because many medications can be associated with discontinuation symptoms, which can be uncomfortable or dangerous and could include worsening anxiety.

    Four classes of medications are the most frequently used for the initial treatment of anxiety disorders: benzodiazepines; selective serotonin reuptake inhibitors, often called SSRIs; serotonin norepinephrine reuptake inhibitors or SNRIs; and tricyclic antidepressants.

    Benzodiazepines are often prescribed for short term management of anxiety. They are highly effective in promoting relaxation and reducing muscle tension and other physical symptoms of anxiety. The other three classes of medications have to be taken on a daily basis in order to begin to take effect, which usually takes two to four weeks.

    SSRIs relieve symptoms by blocking the reabsorption of serotonin by certain nerve cells in the brain. This leaves more serotonin available, and that results in other changes at the cellular level and eventual alleviation of symptoms.

    SNRIs increase the levels of the neurotransmitters serotonin and norepinephrine by inhibiting their reabsorption into cells in the brain. These medications are considered as effective as SSRIs. So they are considered a first-line treatment, particularly for generalized anxiety disorder.

    Tricyclic antidepressants are also effective in treating anxiety disorders, but they are known to be much more difficult to tolerate than the other two classes.

    Dr. Douglas Mennin: Anxiety Disorders can be treated by a wide range of health care professionals: psychologists, psychiatrists, marriage and family therapists, social workers, psychiatric nurses, physicians, nurse practitioners, as well as physician assistants.

    If you like to learn more, visit www.adaa.org and check out our other videos on anxiety and anxiety disorders.