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Table 23 Strength of evidence for pharmacotherapy for GAD

From: Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Agent Level of evidence Agent Level of evidence
Antidepressants
SSRIs   TCAs  
Escitalopram [544552] 1 Imipramine [553, 581583] 1
Paroxetine [546, 547, 553558] 1 Other antidepressants  
Sertraline [556, 559561] 1 Agomelatine [584, 585] 1
Citalopram [562] 3 Vortioxetine [586, 587] 1*
Fluoxetine [563] 3 Bupropion XL [549] 2
Paroxetine CR [564, 565] 3 Trazodone [583] 2
SNRIs   Mirtazapine [588] 3
Duloxetine [566571] 1   
Venlafaxine XR [548, 553, 570580] 1   
Other therapies
Anxiolytics   Atypical antipsychotics  
    Benzodiazepines   Quetiapine XR [551, 557, 602, 603] 1
      Alprazolam [589593] 1 Adjunctive quetiapine [565, 604, 605] 1*
      Bromazepam [589, 594] 1 Adjunctive risperidone [606, 607] 1*
      Diazepam [583, 589, 595, 596] 1 Adjunctive olanzapine [608] 2
      Lorazepam [589, 593, 597601] 1 Adjunctive aripiprazole [269, 609] 3
   Adjunctive quetiapine XR [610] 3
   Adjunctive or monotx ziprasidone [611, 612] 2 (-ve)
Anticonvulsants   Other treatments  
Pregabalin [576, 577, 592, 593, 597, 613] 1 Buspirone [108, 561, 572, 589, 598, 618, 619] 1
Divalproex chrono [614] 2 Hydroxyzine [594, 619, 620] 1
Tiagabine [615, 616] 1 (-ve) Pexacerfont [552] 2 (-ve)
Adjunctive pregabalin [617] 2 Propranolol [621] 2 (-ve)
   Memantine [622] 4 (-ve)
  1. *Conflicting data. SNRI = serotonin–norepinephrine reuptake inhibitor; SSRI = selective serotonin reuptake inhibitor; TCA = tricyclic antidepressant; XL = extended release; XR=extended release; (-ve) = negative.
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