Efficacy and safety of treatments for refractory generalized anxiety disorder: a systematic review.

Summary: When standard treatments for Generalized Anxiety Disorder (GAD) don't work, patients are considered to have "refractory" anxiety. Doctors often try adding a second medication to help, but which ones actually work? A systematic review of clinical trials found that Pregabalin had the strongest evidence for success, significantly reducing anxiety symptoms in a large study. Antipsychotics like Risperidone and Olanzapine also showed promise in smaller studies, but Quetiapine did not perform better than a placebo. Unfortunately, aside from the Pregabalin trial, most studies were too small to be definitive. We need more high-quality research to find safe, effective backup plans for treating anxiety.