Generalised Anxiety Disorder (GAD) and Panic Disorder

Question 1

What physical diagnoses should be ruled out as alternative causes before a diagnosis of Generalised Anxiety disorder is made?

Answer 1

hyperthyroidism
cardiac disease
medication-induced anxiety

Question 2

What medications are known to induce anxiety?

Answer 2

salbutamol
theophylline
corticosteroids
antidepressants
caffeine

Question 3

Non-pharmacological interventions for GAD

Answer 3

individual self-help
group based self-help/ psychoeducation
CBT

Question 4

Pharmacological management of GAD

Answer 4

1st Line = SSRI
2nd Line = alternative SSRI or SNRI
If patient cannot tolerate either - try pregabalin

Question 5

What side effect of antidepressants is usually experienced in the first 2 weeks, and therefore requires weekly follow-up in the first month?

Answer 5

Increased suicidal ideation

Question 6

Treatment of panic disorder

Answer 6

CBT
- SSRIs are first-line drug
- If contraindicated or no response after 12 weeks then offer imipramine or clomipramine