{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:42:48Z","timestamp":1791517368829,"version":"4.3.4"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"unspecified","delay-in-days":167,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS Spectr."],"published-print":{"date-parts":[[2026]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To characterize the treatment burden of generalized anxiety disorder (GAD) using real-world data on pharmacotherapy use, treatment changes, and treatment progression.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective analysis used closed claims from the Komodo Healthcare Map (2021\u20132024) to identify U.S. adults (\u226518\u00a0years) with newly diagnosed or established GAD. Treatment patterns were assessed at the drug level.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among the 259\u00a0158 newly diagnosed and 1\u00a0018\u00a0288 established GAD patients, GAD-related pharmacotherapy use during the 12\u00a0months post-index was 76% and 98%, respectively. Treatment patterns were further analyzed in 59\u00a0275 newly diagnosed and 86\u00a0920 established GAD patients with \u22651 pharmacy claim. Among newly diagnosed patients, 55% discontinued and 28% added or switched treatments; among established patients, 16% discontinued and 55% added or switched treatments. The median time to first treatment event varied by cohort and event type: discontinuation occurred at a median of 84\u00a0days in newly diagnosed and 119\u00a0days in established patients, combination therapy at 49 and 32\u00a0days, and switching at 31 and 42\u00a0days, respectively. Of those who discontinued, 57% of newly diagnosed and 26% of established GAD patients did not resume treatment; among those who restarted, the median treatment gap was 146 and 96\u00a0days, respectively. Overall, 75% of newly diagnosed and 94% of established GAD patients who underwent treatment modification experienced at least one additional therapy change during the study.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This study underscores the significant unmet needs in the current treatment of GAD, evidenced by high rates of pharmacotherapy switching, discontinuation, and prolonged gaps in care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/s1092852926101059","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T12:13:03Z","timestamp":1781698383000},"source":"Crossref","is-referenced-by-count":1,"title":["Treatment instability in generalized anxiety disorder (GAD): a U.S. real-world evidence study"],"prefix":"10.1017","volume":"31","author":[{"given":"Derek","family":"Louie","sequence":"first","affiliation":[{"name":"Definium Therapeutics Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Ferries","sequence":"additional","affiliation":[{"name":"Definium Therapeutics Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Suponcic","sequence":"additional","affiliation":[{"name":"Value and Access Advisors, LLC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Robinson","sequence":"additional","affiliation":[{"name":"Trinity Life Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Lam","sequence":"additional","affiliation":[{"name":"Trinity Life Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Silber","sequence":"additional","affiliation":[{"name":"Trinity Life Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"O\u2019Hara","sequence":"additional","affiliation":[{"name":"Trinity Life Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phong","family":"Duong","sequence":"additional","affiliation":[{"name":"Definium Therapeutics Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Karlin","sequence":"additional","affiliation":[{"name":"Definium Therapeutics Inc"},{"name":"Tufts University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Strawn","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine Department of Psychiatry and Behavi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4733-2523","authenticated-orcid":false,"given":"Roger S.","family":"McIntyre","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03dbr7087","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,6,17]]},"container-title":["CNS Spectrums"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1092852926101059","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:03:11Z","timestamp":1784030591000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1092852926101059\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S1092852926101059"],"URL":"https:\/\/doi.org\/10.1017\/s1092852926101059","relation":{},"ISSN":["1092-8529","2165-6509"],"issn-type":[{"value":"1092-8529","type":"print"},{"value":"2165-6509","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e22"}}