Anxiety guidelines Flashcards
Considerations for baseline lab investigations (as needed based on the patient’s presenting symptoms)
- CBC
- Fasting lipid profile (TC, vLDL, LDL, HDL, TG)
- Electrolytes
- Fasting glucose
- TSH
- Liver enzymes
If warranted: urine tox for substance abuse

First-line pharmacotherapy for panic disorder
All SSRI
- Citalopram
- Escitalopram
- Fluoxetine
- Fluvoxamine
- Paroxetine (+ CR)
- Sertraline
With 1 SNRI
- Venlafaxine

Second-line pharmacotherapy treatments for Panic Disorder
4 Benzos
- Alprazolam
- Clonazepam
- Diazepam
- Lorazepam
2 TCA
- Clomipramine
- Imipramine
2 Others
- Mirtazapine
- Reboxetine

First-line adjunctive therapy for panic disorder
NONE
Second-line adjunctive therapy for panic disorder
- Alprazolam ODT
- Clonazepam

First-line for SAD
4 SSRI (not fluoxetine or citalopram)
- Escitalopram
- Fluvoxamine
- Paroxetine
- Sertraline
1 SNRI:
- Venlafaxine
Other
- Pregabalin

Second-line for SAD
3 Benzos
- Alprazolam
- Bromazepam
- Clonazepam
Others:
- Citalopram
- Phenelzine (Nardil)
- Gabapentin

Adjunctive therapy - not recommended for SAD
- Clonazepam
- Pindolol

First-line GAD
3 SSRI
- Escitalopram
- Paroxetine
- Sertraline
2 SNRI
- Venlafaxine
- Duloxetine
Other:
- Pregabalin
- Agomelatine

Second-line GAD
4 Benzos
- Alprazolam
- Bromazepam
- Diazepam
- Lorazepam
3 Other antidepressants:
- Vortioxetine
- Bupropion
- Imipramine
3 Others:
- Buspirone
- Hydroxyzine
- Quetiapine XR

First-line adjunctive for GAD
None
Second-line adjunctive for GAD
Pregabalin

First-line for OCD
5 SSRI
- Escitalopram
- Fluoxetine
- Fluvoxamine
- Paroxetine
- Sertraline

Second-line OCD
1 SSRI
- Citalopram
1 SNRI
- Venlafaxine
1 TCA
- Clomipramine
Others:
- Mirtazapine

First-line adjunctive OCD
- Aripiprazole
- Risperidone

Second-line augmentation for OCD
- Memantine
- Quetiapine
- Topiramate

First-line PTSD
3 SSRI
- Fluoxetine
- Paroxetine
- Sertraline
1 SNRI
- Venlafaxine XR

Second-line PTSD
- Fluvoxamine
- Mirtazapine
- Phenelzine

First-line adjunctive therapy PTSD
NONE
Second-line adjunctive therapy PTSD
- Eszopiclone
- Olanzapine
- Risperidone

Not recommended PTSD
2 Benzos
- Alprazolam
- Clonazepam
Others:
- Citalopram
- Desipramine
- Divalproex
- Olanzapine
- Tiagabine
