NICE gudline for anxiety and panic

Question 1

Mild GAD MANAGEMENT step 1

Answer 1

Education and active monitoring
Low intensity psychological intervention

Question 2

mild GAD no response to step 1

Answer 2

Individual non fascilitated self help (cbt based)
Individual self help
Psychoeducational groups (cbt based)

Question 3

Failed step 2 GAD or marked functional imapirment

Answer 3

CBT
or
Drugs

Question 4

Failed GAD step 3 management

Answer 4

Specialist Rx

Drug and psychological Rx
Input from Multiple agency, Crisis Management, Day hospital, inpatient care

Question 5

How long benzo can be used in crisis (GAD)

Answer 5

2-4 week

Question 6

First line of treatment in GAD

Answer 6

ssri ( sertraline)

Question 7

For patients under age of 30 with GAD on SSRI, what precaution

Answer 7

Risk of suicidality

So monitor weekly for first month

Question 8

Should antipsychotic be offered in primary care?

Answer 8

Nope! Never for GAD

Question 9

what if patient did not respond to SSRI and SNRI

Answer 9

pregabalin

Question 10

how long to continue medications in GAD

Answer 10

1 year

Question 11

Can benzodiapine be used with panic disorders

Answer 11

Nope
nor sedatives antihistamin and antipsychotics

Question 12

1st line of Rx in Panic Disorder

Answer 12

SSRI

Question 13

if SSRI failed in Panic disorder

Answer 13

Imipramine and clomipramine

Question 14

How long an ssri can be tried before changing the class or drug in panic disorder

Answer 14

12 weeks

Question 15

How long SSRI continue after optimal dose reached?

Answer 15

6 months then taper