Handbook of Generalised Anxiety Disorder by Stuart A Montgomery PDF

By Stuart A Montgomery

Authored via a well-known specialist, the instruction manual of Generalised anxiousness ailment presents a common and complete evaluation of this crucial condition.

Well identified writer, complete overview in a concise format

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Sertraline was effective on both the psychic symptoms and the somatic symptoms although the treatment effect on the somatic symptoms was less substantial. The mean dose in the study was approximately 95 mg/day but, because of the flexible dosage regimen and the slow conservative upward titration of the dose, it is not possible to determine the contribution of the higher and lower doses. 62 This study also found that sertraline was effective compared with placebo at the endpoint measured by the HAM-A.

It is effective in the treatment of pain and, as GAD is frequently comorbid with pain disorders and pain is a presenting symptom in as many as a third of GAD patients, this is a clear advantage, particularly when compared with SSRIs or benzodiazepines which are not thought to be effective in pain disorders. 84 Pregabalin is well tolerated with a level of adverse events comparable to that seen on placebo. The number of patients who discontinued treatment with pregabalin in the studies due to adverse events was small (11%), close to the number on placebo (9%), and compares very favourably with the 20% of patients who discontinued venlafaxine at the lowest dose, or 35% who discontinued lorazepam in the comparator studies.

The question mark over the efficacy of the benzodiazepine in this study is also underlined by the greater treatment effect observed with imipramine in the same study. 93 This leads to a very real concern that negative results often remain unpublished and that the efficacy of diazepam may not be strong. &/54 t  the efficacy of pregabalin, in which benzodiazepines were included as reference agents. 80,81 At this high dose of lorazepam there were numerous dropouts (35%), higher than seen with pregabalin (11%) which was close to the placebo rate (9%).

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