Medline ® Abstract for Reference 40

OBJECTIVE: This article reports on the pharmacologic treatment of patients diagnosed with generalized anxiety disorder (GAD) enrolled in a naturalistic long-term study of anxiety disorders, with enrollment in 1989 through 1991 and follow-up in 1996.

METHOD: 711 patients were enrolled in the study during 1989-1991. At intake, 167 patients met DSM-III-R criteria for GAD; at 1996 follow-up, 103 patients met these criteria. The patients were divided into 3 groups by diagnosis: GAD alone (N = 18 at intake, N =11 at follow-up), GAD comorbid with another anxiety disorder (N = 84 at intake, N = 52 at follow-up), and GAD comorbid with Research Diagnostic Criteria-defined major depressive disorder, with or without another anxiety disorder (N = 65 at intake, N = 40 at follow-up). The groups were evaluated at intake and follow-up on whether they received medication and the types of medication they received.

RESULTS: Nearly one third of patients in the 1989-1991 sample were not receiving any medication for treatment of their anxiety disorder; in 1996, 27% of patients still were receiving no medication. There was adecrease in benzodiazepine treatment and an increase in antidepressant treatment in 1996 for GAD patients who did not have comorbid depression or another anxiety disorder.

CONCLUSION: The finding of one quarter to one third of patients with GAD receiving no medication is consistent with previous observations of undertreatment of depression. The findings on medication type suggest a shift in the type of medications being prescribed for treatment of GAD from exclusive benzodiazepine treatment to the combination of benzodiazepine and antidepressant treatment.