We thank Drs. Zoberi and Pollard for their update on therapeutic options for generalized anxiety disorder (GAD) (Treating anxiety without SSRIs, J Fam Pract. 2010;59:148-154). Our only critique is that they focused almost exclusively on pharmacologic and herbal options. Although cognitive behavioral therapy (CBT) was mentioned as an adjunct therapy in 1 clinical trial, the opportunity to more fully discuss its effectiveness both as monotherapy and in conjunction with other therapies was missed.
A recent Cochrane review on psychological treatments for GAD singled out CBT as being an effective short-term intervention.1 Also, the British National Institute for Health and Clinical Excellence guideline for anxiety suggests that primary care be the point of entry for those with GAD, and CBT—for which there is evidence of the longest duration of effect—be a first line of treatment.2
In the era of the patient-centered medical home and heightened awareness of behavioral health in family medicine, CBT’s importance as a treatment option for GAD should have been more thoroughly explored.
Timothy Mott, MD
Naval Hospital Pensacola, Fla
Robert Schlegel, PsyD
Naval Hospital Beaufort, SC
The opinions expressed here are those of the authors and do not necessarily reflect the position of the Navy Medical Department or the naval service at large.