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Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review

机译：成人和儿科患者广义焦虑症的药物疗法：基于证据的待遇审查

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Introduction: Generalized anxiety disorder (GAD) often begins during adolescence or early adulthood and persists throughout the lifespan. Randomized controlled trials support the efficacy of selective serotonin and selective serotonin norepinephrine reuptake inhibitors (SSRIs and SNRIs, respectively), as well as benzodiazepines, azapirones, anti-adrenergic medications, melatonin analogs, second-generation antipsychotics, kava, and lavender oil in GAD. However, psychopharmacologic treatment selection requires clinicians to consider multiple factors, including age, co-morbidity, and prior treatment. Areas covered: The authors review the literature concerning pharmacotherapy for pediatric and adult patients with GAD with specific commentary on the efficacy and tolerability of selected agents in these age groups. The authors describe an algorithmic approach to the pediatric and adult patient with GAD and highlight considerations for the use of selected medications in these patients. Expert opinion: In adults with GAD, SSRIs and SNRIs represent the first-line psychopharmacologic treatment while second-line pharmacotherapies include buspirone, benzodiazepines, SGAs, and pregabalin. In pediatric patients with GAD, SSRIs should be considered the first line pharmacotherapy and psychotherapy enhances antidepressant response.
机译：介绍：广义焦虑症（GAD）经常在青春期或成年早期开始，并且在整个寿命期间持续存在。随机对照试验支持选择性血清素和选择性血清素Norepinephrine肾上腺素再摄取抑制剂（SSRIS和SNRIS）的功效，以及苯二氮卓，Azapirones，抗肾上腺素能药物，褪黑激素类似物，第二代抗精神病药，Kava和薰衣草油。然而，精神医学治疗选择需要临床医生考虑多种因素，包括年龄，共发病率和先前治疗。涵盖领域：作者审查了对小儿和成年患者的药物治疗的文献，具有对这些年龄组中选定药剂的疗效和耐受性的特定评论。作者描述了具有GAD的儿科和成人患者的算法方法，并突出了这些患者在这些患者中使用所选药物的考虑。专家意见：在Gad的成年人中，SSRIS和SNRI代表一线精神牧业治疗，而第二线药拍包括Buspirone，苯二氮卓，SGA和普瑞巴林。在小儿科的Gad患者中，SSRI应该被认为是第一线药物治疗和心理治疗增强抗抑郁症反应。

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