Anxiety medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]
Overview
The mainstay of therapy for anxiety is the administration of pharmacotherapy and psychotherapy
Antidepressant]]s Benzodiazepines (some concern over dependency), buspirone, tricyclic antidepressants ,SSRIs (selective serotonin reuptake inhibitors)
Medical Therapy
Pharmacotherapy
Generalized anxiety disorder:
The first line treatment for generalized anxiety disorder is SSRI:
- Sertraline (Zoloft) is the initial drug of choice:
- Start with initial oral dose of 25 mg once daily for 1 week, increase it based on response and tolerability; maximum dose is 200mg/day
- Alternatively SSRI's that can be used are
- Citalopram(initial dose-10mg) with daily dose ranging from 10-40mg
- Escitalopram (initial dose-5-10mg)with daily dose ranging from 10-20mg
- Paroxetine(initial dose 20mg) with daily dose ranging from 20-50mg
Other classes of drugs that can be used are :
SNRI's-
- DUloxetine(initial dose 30mg) with daily dose ranging from 60-120mg
- Venlafaxine(initial dose 75mg) with daily dose ranging from 75-225mg
Other drugs to consider:
- Buspirone ( initial dose is 10mg) with daily dose ranging from 10-60mg
- Pregabalin(initial dose is 50mg) with daily dose ranging from 50-300mg
- Hydroxyzine(
- Mirtazapine)
Psychotherapy
- CBT is a type of psychotherapy that can help people with anxiety disorders. It teaches a person different ways of thinking, behaving, and reacting to anxiety-producing and fearful situations. CBT can also help people learn and practice social skills, which is vital for treating social anxiety disorder.
- Two specific stand-alone components of CBT used to treat social anxiety disorder are cognitive therapy and exposure therapy. Cognitive therapy focuses on identifying, challenging, and then neutralizing unhelpful thoughts underlying anxiety disorders.
- Exposure therapy focuses on confronting the fears underlying an anxiety disorder in order to help people engage in activities they have been avoiding. Exposure therapy is used along with relaxation exercises and/or imagery. One study, called a meta-analysis because it pulls together all of the previous studies and calculates the statistical magnitude of the combined effects, found that cognitive therapy was superior to exposure therapy for treating social anxiety disorder.
- CBT may be conducted individually or with a group of people who have similar problems. Group therapy is particularly effective for social anxiety disorder. Often “homework” is assigned for participants to complete between sessions.[1]
References
- ↑ Kivity Y, Huppert JD (2016). "Does cognitive reappraisal reduce anxiety? A daily diary study of a micro-intervention with individuals with high social anxiety". J Consult Clin Psychol. 84 (3): 269–83. doi:10.1037/ccp0000075. PMID 26795939.