Management of anxiety disorders

Question 1

Graded exposure

• treats what?
• what is it?
• patter of exposure?

Answer 1

-used to treat simple phobias

-involves counter conditioning- the same stimuli are eventually associated with calmness and control
build a hierarchy of feared stimuli and teaching person relaxation in order to manage anxiety

-gradual and progressive exposure

Question 2

Flooding

-involves what?

Answer 2

-full exposure to the feared stimulus and staying with it till fear reduced

Question 3

CBT

-principles?

Answer 3

-underlying thoughts effect emotions which effect behaviour so by involving the patient in question/testing their thoughts, you can influence their behaviour and emotions

Question 4

PTSD management

• Medication? (4)
• Psychological? (2)

Answer 4

-SSRIs (escitalopram, fluoxetine)
Venlafaxine, phenelzine
Some benzos
Anticonvulsants (gabapentin, pregabalin, olanzapine)

-CBT
eye movement desensitisation and reprocessing

Question 5

OCD management

• Medication? (3)
• Psychological? (2)

Answer 5

-serotonergic ADs (SSRIs, Clomipramine)
augment with antipsychotics (Risperidone, Aripiprazole)
some anticonvulsants (Lamotrigine)

-exposure and response prevention (FIRST LINE)
CBT

Question 6

GAD management?

• Medication? (3)
• Psychological? (3)

Answer 6

-SSRI first line
SNRIs (Venlafaxine, duloxetine)
pregabalin

-Guided self help
CBT
relaxation (short term)

Question 7

Social phobia

• Medication? (4)
• Psychological? (3)

Answer 7

-SSRIs
Venlafaxine, phenelzine
some benzos (Bromazepam, Clonazepam)
Anticonvulsants (gabapentin, pregabalin)

-CBT
Cognitive restructuring
Social skills training

Question 8

Specific phobia

• Medication? (1)
• Psychological? (1)

Answer 8

• SSRIs (mod-sev)

- exposure therapy

Question 9

panic disorder +/- Agoraphobia

• Medication? (4)
• Psychological? (2)

Answer 9

-All SSRIs
some TCAs
venlafaxine
some anticonvulsants (gabapentin, valproate)

-CBT
graded exposure