Anxiety - BNF

Question 1

How would you generally manage acute anxiety

Answer 1

BZDPN or buspirone

Question 2

How would you manage chronic anxiety

Answer 2

For chronic anxiety (of longer than 4 weeks’ duration) it may be appropriate to use an antidepressant. Combined therapy with a benzodiazepine may be required until the antidepressant takes effect.

Question 3

Management of GAD (a form of chronic anxiety)

Answer 3

1. Psychological treatment
2. SSRI: escitalopram, paroxetine, sertraline (unlicensed) or SNRIs
3. Pregabalin

Question 4

Management of panic disorder

Answer 4

1. SSRIs, venlafaxine also licensed
2. Clomipramine or imipramine 2nd line - both are unlicensed

Question 5

Management of OCD, PTSD, phobic states e.g. social anxiety disorder

Answer 5

SSRIs.
Clomipramine hydrochloride can be used 2nd-line for OCD
Moclobemide is licensed for the treatment of social anxiety disorder.

Question 6

SSRI is first line for OCD. Whats second line?

Answer 6

clomipramine

Question 7

Following remission of GAD, how long to continue AD treatment?

Answer 7

Following remission, antidepressant treatment should be continued at the same dose for at least 12 months in patients receiving treatment for generalised anxiety disorder (as the likelihood of relapse is high).