Brazilian Psychiatric Association guidelines for the treatment of generalized anxiety disorder (GAD). Pharmacological and Psychotherapy approach. Perspectives

Braz J Psychiatry. 2023 Nov 13. doi: 10.47626/1516-4446-2023-3235. Online ahead of print.

Abstract

Objective: To combine elements of a systematic review and critical review to produce best evidence synthesis for the treatament of GAD.

Method: There was included systematic reviews, metanalysis, and randomized controlled trials. Descriptor used was "generalized anxiety disorder", resulting in 4860 articles and 7 other studies, of which 59 were selected.

Results: Antidepressants and benzodiazepines are indicated, as well as pregabalin. From, atypical antipsychotics quetiapine has been studied. Cognitive behavior therapy (third wave of behavioral and cognitive therapies) as well as individual CBT proven to be effective.

Conclusion: There is extensive literature on many effective treatments for GAD. The present work summarizes the therapeutic possibilities, emphasizing those available in the Brazil. Further studies are still needed to compare other available medications, to assess psychotherapies in more depth, new treatments and specially to assess the ideal time for maintaining therapy.

Keywords: Generalized anxiety disorder; anxiety disorders; mental health; treatment.