ICD-11 Criteria for Generalised Anxiety Disorder (GAD) Foundation URI:   http://id.who.int/icd/entity/1712535455 Description Generalised anxiety disorder is characterised by marked symptoms of anxiety that persist for at least several months, for more days than not, manifested by either general apprehension (i.e. ‘free-floating anxiety’) or excessive worry focused on multiple everyday events, most often concerning family, health, finances, and school or work, together with additional symptoms such as muscular tension or motor restlessness, sympathetic autonomic over-activity, subjective experience of nervousness, difficulty maintaining concentration, irritability, or sleep disturbance. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. The symptoms are not a manifestation of another health condition and are not due to the effects of a substance or medication on the centra

Psychotherapy      Reassurance Self-help and psychoeducation à Pure self-help, guided self-help, group psychoeducation Relaxation therapy à applied relaxation, progressive muscle relaxation, deep breathing exercises Cognitive behavior therapy Exercise Pharmacotherapies Indications of pharmacotherapy While on psychotherapy, short-term Psychotherapy ineffective, Psychotherapies not available First-line         Selective Serotonin Reuptake Inhibitors à These and SNRIs may initially exacerbate symptoms; a lower starting dose is often required.   Fluoxetine and sertraline are preferred options.   Sertraline is the most tolerable and cost effective, recommended as first choice by NICE. Fluoxetine is most effective choice. Effexor (venlafaxine) SR up to 225 mg/day Dulan/Duron (duloxetine) up to 60 mg/day pregabalin 150–600 mg/day Second-line choices             Agoviz (agomelatine) 25 mg                2 x nocte Agoviz (agomelatine) 25 mg