Generalized Anxiety Disorder Study

Principal Investigator: Paul Crits-Christoph, PhD (NIMH funded)

Investigators at the Center for Psychotherapy Research conducted a study of state-of-the-art cognitive behavioral therapy in combination with medication in the treatment of GAD. In this study, some of the patients receiving medication treatment for their Generalized Anxiety Disorder were also offered the option of adding cognitive behavioral therapy (CBT) to their medication treatment. Karl Rickels, MD was the Principal Investigator of this study funded by the National Institute of Mental Health (NIMH).

Symptoms of Generalized Anxiety Disorder include:

  • Feelings of uncontrollable worry and anxiety most of the time
  • Experiencing some of the following symptoms for at least 6 months:
  • Restlessness
  • Fatigue
  • Difficulty concentrating
  • Muscle tension
  • Irritability
  • Sleep disturbance

Of all major mood and anxiety disorders, Generalized Anxiety Disorder (GAD) represents one of the most common, but least studied disorders. Although medications and cognitive-behavioral therapies (CBT) have demonstrated efficacy in GAD treatment, a substantial number of patients fail to achieve an adequate clinical response during acute phase treatment. Thus, it is important to attempt to improve outcomes in GAD.

Combined Treatment for Generalized Anxiety Disorder Study

The "Combined Treatment for Generalized Anxiety Disorder" study was a preliminary randomized clinical trial evaluating the efficacy of combined medication and psychotherapy for Generalized Anxiety Disorder (GAD). The current study assessed efficacy of combined cognitive behavioral therapy (CBT) and venlafaxine XR compared to venlafaxine XR alone in the treatment of generalized anxiety disorder (GAD) within settings where medication is typically offered as the treatment for this disorder. Patients with DSM-IV–diagnosed GAD who were recently enrolled in a long-term venlafaxine XR study were randomly offered (n=77) or not offered (n=40) the option of adding 12 sessions of CBT.


Of those offered CBT, 33% (n=26) accepted and attended at least one treatment session.

The outcome results indicated no differences between the combined treatment group and the medication only group on primary or secondary efficacy measures in any of the sample comparisons. Many patients who present in medical/psychopharmacology settings seeking treatment for GAD decline the opportunity to receive adjunctive treatment. Of those that receive CBT, there appears to be no additional benefit of combined treatment compared to venlafaxine XR alone.

The results of the study are described in the primary article:

Crits-Christoph, P., Newman, M. G., Rickels, K., Gallop, R., Gibbons, M. B. C., Hamilton, J. L.,  Ring-Kurtz, S., & Pastva, A. M. (2011). Combined medication and cognitive therapy for generalized anxiety disorder.Journal of Anxiety Disorders, 25(8), 1087-1094.

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This study is now closed for recruitment.

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