Patients starting an SNRI should be monitored for efficacy of treatment as well as tolerability.
When starting an SNRI, the patient’s other health problems should also be assessed by the healthcare provider to ensure that it is the correct medication.
A prescribing algorithm for GAD treatment is available at
Below we provide an overview of some alternative medications that can be used for treatment of anxiety and the role of pharmacogenetic variations that impact on tolerability and response.Acknowledgments: The author would like to thank Ms. Bridget Banas for her assistance in the preparation of this manuscript. Duloxetine (Cymbalta) and venlafaxine (Effexor) are SNRIs that are FDA-approved for the treatment of GAD.Duloxetine may also be useful for patients suffering from neuropathic pain and fibromyalgia.