Generalized anxiety disorder in real-world clinical practice: Prospects for diagnosis and treatment

Anxiety disorders are among the most common forms of mental illness in the modern world, and one of the most significant is generalized anxiety disorder. This disorder is characterized by long-term, persistent, and severe anxiety about various issues, as well as numerous distressing sensations in the body, fatigue, sleep disturbances, and pain symptoms. Numerous studies have shown that untreated generalized anxiety disorder significantly reduces patients’ quality of life, increases the risk of disability, and negatively impacts the course of a number of socially and clinically significant somatic diseases. Despite the large number of developed diagnostic and therapeutic methods, managing patients with this disorder in real-world clinical practice remains a challenging task, requiring the clinician to select differentiated therapeutic interventions. According to current data, lifestyle modification recommendations, psychotherapeutic interventions (primarily cognitive behavioral therapy), and psychopharmacotherapy can be effective in treating generalized anxiety disorder. Monoamine reuptake inhibitors are the first-line psychopharmacotherapy for generalized anxiety disorder, and benzodiazepine tranquilizers have the most pronounced rapid anti-anxiety effect. However, both classes of medications are not without side effects and drawbacks, limiting their universal use in all patients with generalized anxiety disorder. This article concludes with two case reports demonstrating how the non-benzodiazepine anxiolytic original etifoxine may be a useful treatment option for generalized anxiety disorder, depending on the clinical situation, either as monotherapy or as an adjunct to a serotonin-norepinephrine reuptake inhibitor.

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