Generalised anxiety disorder – easing burden and enabling remission ACG

Published on 26 March 2025

This ACE Clinical Guideline (ACG) highlights non-pharmacological and pharmacological management of generalised anxiety disorder to achieve remission and reduce the risk of relapse. The ACG offers evidence-based recommendations on assessment for treatment planning, selection of psychological and/or pharmacological treatment, and strategies for inadequate response. Appropriate use of benzodiazepines is also discussed.

Though the guideline focuses on adults (patients 18 years old and above), brief supplementary resources on assessment and management in perinatal women, as well as children and adolescents, are included.

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Generalised anxiety disorder – easing burden and enabling remission (Mar 2025) [PDF]

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ACG recommendations

1. Select the treatment approach by assessing GAD severity and other factors, taking into account the needs, preferences, and readiness of the patient.

2. For patients with mild GAD:

   1. Consider CBT-based psychological treatments as first-line.

   2. Consider medication if psychological treatments are not feasible or acceptable.

3. For patients with moderate GAD:

   1. Offer a CBT-based psychological treatment or an SSRI/SNRI medication.

   2. Consider a combination of both modalities if supported by clinical need.

4. For patients with severe GAD, offer a combination of CBT-based psychological treatment and SSRI/SNRI medication as first-line.

5. If treatment does not achieve adequate response in patients with GAD, assess possible reasons before considering modifying treatment or seeking specialist advice.

6. Continue treatment with an SSRI or SNRI for at least six months after achieving remission.

7. Do not routinely prescribe benzodiazepines as first-line treatment for GAD.

Refer to the Evidence-to-Recommendation (EtR) framework below for a summary of the factors underpinning the ACG’s recommendations.

ACG references and EtR framework

Click below to see the list of references for the generalised anxiety disorder ACG.

Generalised anxiety disorder – easing burden and enabling remission references (Mar 2025) [PDF]

The Evidence-to-Recommendation (EtR) framework is a document that outlines the underpinning evidence and rationale for the recommendations in our ACGs. Download the generalised anxiety disorder EtR framework below to learn more about factors that have informed the strength of the ACG recommendations, including certainty of evidence, clinical benefit/risk balance, local resource implications, feasibility considerations, patient preferences and values.

Generalised anxiety disorder – easing burden and enabling remission EtR framework (Mar 2025) [PDF]