Treat GAD for one year instead of six months

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If effective continue SSRI or SNRI in generalized anxiety disorder for at least 12 months rather than the 6 months.

Selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) are first-line medications for the treatment of generalized anxiety disorder (GAD).

In a randomized trial, 136 patients with GAD who experienced reduced anxiety during six months of treatment with venlafaxine were continued the drug or to placebo for another six months. Patients continuing venlafaxine had a lower rate of relapse with no additional side effects.

If the patient experiences a relapse following termination of an effective medication, the length of treatment can be extended. After two relapses when tapering off the medication, ongoing maintenance treatment should be considered.

Reference

Rickels K, Etemad B, Khalid-Khan S, et al. Time to relapse after 6 and 12 months’ treatment of generalized anxiety disorder with venlafaxine extended release. Arch Gen Psychiatry 2010;67:1274.