Generalized Anxiety Disorder (GAD)


Main Concepts:

Notable Features:

High Yield:

  • Anxiety is excessive, distressing, and impairing


  • Most patients report a lifelong history of anxiety (history of chronic anxiety predating the onset of recent stressors).

  • Typically, patients experience worsening symptoms during periods of increased stress.


Generalized anxiety disorder is characterized by excessive, uncontrollable anxiety about multiple issues, found in conjunction with 3+ of the following symptoms for at least the last 6 months:

  1. Restlessness

  2. Muscle tension

  3. Fatigue

  4. Impaired sleep

  5. Irritability

  6. Poor concentration




First-line treatment options for GAD include:

  • Pharmacotherapy with SSRIs or SNRIs

  • CBT

Buspirone is a second-line agent and anxiolytic used in the treatment of GAD. Its mechanism of action is unknown, but it is known to have high affinity for the 5-HT1A and 5-HT2 receptors, as well as moderate affinity for D2 receptors.