This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Treatment of anxiety disorder

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

There are two approaches to the management of anxiety:

  • pharmacological
    • review of the evidence revealed that treatments likely to be beneficial in treatment of panic disorder include (1):
      • selective serotonin reuptake inhibitors
      • tricyclic antidepressants e.g. imipramine
  • psychological e.g. cognitive behavioural therapy

Treatment also involves:

  • education about the condition
  • distraction strategies
  • breathing exercises

NICE recommends the following approach: (2)

Step 1: all known and suspected presentations of GAD
Identification, assessment, education, monitoring.

Step 2: diagnosed GAD that has not improved after education and active monitoring in primary care
Low-intensity psychological support, non-facilitated or guided self-help, psycho-educational groups.

Step 3: GAD with an inadequate response to step 2 interventions or marked functional impairment
Cognitive behavioural therapy (CBT)/applied relaxation or drug treatment.

Step 4: complex treatment-refractory GAD and very marked functional impairment, such as self-neglect or a high risk of self-harm
Specialist drug and/or psychological treatment, multi-agency teams, crisis intervention, outpatient or inpatient care.

There are frequently comorbid conditions - eg, depression, substance abuse - which may need treating too. NICE recommends that the most severe condition be treated first. If treating a child or adolescent, be much more reluctant and cautious about prescribing.

Notes:

  • if benzodiazepines are used in the management of panic disorder then there is a trade off between benefits and harms

Reference:

  1. Clinical Evidence. BMJ (March 2006)

2. Overview | Generalised anxiety disorder and panic disorder in adults: management | Guidance | NICE (https://www.nice.org.uk/guidance/cg113)


Related pages

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.