Generalized anxiety disorder (GAD) is a chronic, debilitating condition characterized by excessive and persistent worrying that interferes with many aspects of daily life. Symptoms include both somatic symptoms, such as tremor and palpitations, and psychic symptoms, particularly apprehensive expectations about major and minor concerns. Evidence-based treatment approaches for GAD comprise pharmacotherapy and psychotherapy (including cognitive therapy), or a combination of the two. First-line pharmacotherapeutic agents include selective serotonin reuptake inhibitors, serotonin-noradrenaline reuptake inhibitors, and, in certain European guidelines, pregabalin, which gained European Commission approval. Although short- and long-term efficacies have established for these agents in controlled trials, response rates of 60-70% are insufficient, remission rates are 30-40%, and relapse rates are marked. GAD is a multifactorial stress-related affective disorder resulting from both proximal and distal risk factors, some of them being potentially modifiable by health care intervention.
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