Nada Zahreddine and Sami Richa Pages 86-96 (11)
Methods: The purpose of this review is to discuss all non-antidepressant treatments studied in GAD. We searched MedLine for English articles published between 1980 and 2012, containing the following keywords: “generalized (or generalised) anxiety disorder” OR “anxiety disorder”, AND “drug therapy” OR “herbal medicine”. 76 articles were finally selected.
Results: Pregabalin is the anticonvulsant with the most robust level of evidence in GAD. It rapidly reduces anxiety, has a safe side effect profile and presents a low potential for abuse. Among antipsychotics, quetiapine is the one of choice in GAD, with similar efficacy to SSRIs in low dosages, yet with lower overall tolerability. Benzodiazepines, buspirone and hydroxyzine are Food and Drugs administration (FDA) approved for GAD and have relatively good evidence of efficacy. Other drugs (betablockers, zolpidem, riluzole, etc.) and natural remedies (e.g. Piper methysticum) could be potential treatment options, yet additional research is warranted.
Conclusion: Pregabalin and quetiapine are the two most promising non-antidepressant treatments for GAD.
Anticonvulsants, antipsychotics, drug therapy, generalized anxiety, herbal treatment, pregabalin, quetiapine.
Hôtel-Dieu de France University Hospital, Achrafieh, Lebanon.