Psychiatry

Question 1

describe the management of generalised anxiety disorder and panic disorder

Answer 1

• education about GAD + active monitoring
• low intensity psychological interventions (self-help)
• high-intensity psychological interventions (CBT) or drug treatment

drug treatment
- sertraline as first-line SSRI
- if ineffective, use an alternative SSRI or SNRI e.g. duloxetine, venlafaxine
- offer pregabalin if these are not tolerated
- propranolol for acute anxiety

panic disorder
- CBT / drug therapy
- SSRIs are first-line, try imipramine or clomipramine if unsuccessful

Question 2

list the SSRIs of choice in the following patient populations
- breastfeeding women

Answer 2

• breastfeeding women: sertraline or paroxetine