Transcript Anxiety
Guidelines on Anxiety Dr Jothi Murugan Prevalence 5-10% C/F Apprehension Cued panic attacks Irritability Poor sleeping Avoidance Poor concentration Physical symptoms Panic disorder with or without agoraphobia • Intermittent episodes of panic or anxiety and taking avoiding action to prevent these feelings Generalised anxiety disorder Over-arousal irritability poor sleeping worry about several areas most of the time Agoraphobia, social phobia or simple phobia • Episodes of anxiety triggered by external stimuli Recognition and Diagnosis H/o: self medication cultural characteristics Associated depression Substance abuse Medical h/o :Hyperthyroidism Recognition and Diagnosis Minimum tests to exclude physical problems Not usually be admitted Written info about the condition and support available Management of panic disorder in primary care CBT 7-14 hours (4 months) SSRI, if not suitable or no response in 12 weeks imipramine or clomipramine No Benzodiazepines, sedative antihistamines or antipsychotics Management of panic disorder in primary care Self help: Exercise, support group, computerised CBT Refer if trial of 2 treatments don’t work Generalised anxiety disorder CBT 6-20 sessions over 4 months Antidepressant medication: Paroxetine, venlafaxine self-help Swap treatment after 12 weeks if not beneficial Betablockers for physcial symptoms Generalised anxiety disorder If after two interventions provided and the person still has significant symptoms, referral to specialist mental health services Phobia Agoraphobia, fear of the market place, multiple phobic symptoms and a generalised high level of anxiety. Specific phobias Phobia management CBT Desensitisation Diazepam 5-10 mg 2 hours prior to dental procedures Thank you