When Anxiety Persists: Evidence-Based Strategies and Novel Pharmacologic Options Beyond First-Line Treatment

Many patients with generalized, panic, or mixed anxiety disorders experience only partial relief from first-line SSRIs and SNRIs, leaving clinicians uncertain about how to proceed. This session provides a comprehensive, step-by-step framework for evaluating treatment-resistant anxiety and selecting next-line interventions. Faculty will review systematic assessment tools, rational sequencing strategies, and integration of psychotherapy to enhance response. The session will also highlight evidence-informed off-label and emerging pharmacologic options, including gabapentinoids, atypical antipsychotics, buspirone optimization, beta blockers, alpha-agonists, hydroxyzine, and agents targeting glutamatergic and GABAergic systems. Participants will gain practical guidance for delivering safe, individualized, and accountable anxiety care when standard treatments fall short.