Strategies for Treatment of Generalized Anxiety in the Primary Care Setting

Generalized Anxiety Disorder (GAD) is a highly prevalent condition whose course of illness isoften chronic in nature and fluctuating in severity. Pharmacotherapy options include the benzodiazepines,the azapirones, of which only buspirone is marketed at the present time, and the antidepressantimipramine. Buspirone is probably the treatment of choice when prolonged therapy is indicated becauseit does not produce physical dependence, dose not interact with alcohol, and does not cause psychomotorimpairment. Dosing instructions for buspirone and guidelines for switching patients frombenzodiazepines to buspirone are offered. Non-drug therapies such as interpersonal and cognitivetherapies are often also found helpful in treating patients with GAD.