Efficacy for treatment of GAD has been established for several different drug classes. At present, based on clear efficacy and good tolerability, first-line treatment with either a selective serotonin reuptake inhibitor (SSRI) or a serotonin-norepinephrine reuptake inhibitor (SNRI) is indicated. If an initial, at least moderate, clinical response is achieved under antidepressant therapy, treatment should be at least continued for 12 months.

Although ADs remain the most frequently prescribed medications for GAD, alternative and off-label therapies such as pregabalin, the atypical antipsychotics and vortioxetine are garnering interest. Based on the evidence available to us, it is our recommendation that along with the ADs, benzodiazepines be considered a possible first-line therapy in eligible patients based on the discretion and clinical judgment of the treating physician.

No abstract

Objectives. To develop a pilot study to assess the effectiveness of a Web-based educational module on enhancing understanding of substance abuse and drug diversion, and to assess students' abilities and confidence in applying the information. Design. A Web-based instructional module was presented to students enrolled in their second preprofessional year, and students were informed that it was part of a research study. Knowledge was tested using 10 pre-and post-module questions. Students were also presented with 5 survey questions assessing abilities related to the learning objectives. Assessment. The median percentage of correct responses increased from 60% (Interquartile range [IQR] 20%) for the pre-module questions to 90% (IQR 5 10%) for the post-module questions. The median percent gain in knowledge was 20% (IQR 5 20%) which was significant (p , 0.0001). Conclusions. Web-based instruction is an alternative method for engaging students in course content. We found that 59% of our pilot study group worked in a pharmacy. From the success of the pilot study, the module was implemented as an extra credit assignment in a required course to provide a foundation for developing professional responsibility.

The data available in the literature so far indicate clinical efficacy over placebo and a rather benign adverse event profile. Whether the early onset of clinical efficacy observed in one of the two pivotal studies represents a true or only a chance phenomenon, only future studies can tell. Adverse effects are mostly mild-moderate and most GI type AEs disappear in about one week, at a time when all patients are still on a clinically suboptimal daily dosage (10 mg/d during the first week). Sexual AEs did not differ from placebo. Vilazodone represents an interesting addition to the arsenal of available antidepressants.