Psychiatry Essentials for Primary Care by Robert K. Schneider & James L. Levenson

Author:Robert K. Schneider & James L. Levenson [Schneider, Robert K.]
Language: eng
Format: mobi
Tags: ebook
Publisher: American College of Physicians
Published: 2007-11-15T05:00:00+00:00

Box 7-4 General Principles for the Treatment of Subsyndromal Anxiety

Find out if the current symptoms are residual symptoms of a full criteria disorder.

Ask if there is a family history of anxiety disorders.

Use a conservative approach.

Provide close follow up.

Pharmacologic treatment for isolated anxiety symptoms primarily consists of antihistamines and benzodiazepines. Hydroxyzine and diphenhydramine both have anxiolytic effects, which are often associated with sedation and anticholinergic side effects (e.g., dry mouth, sedation, urinary retention). Antihistamines are good short-term medications when used at night in younger patients who can tolerate their side effects, but they are not a good choice in older patients because their anticholinergic properties can cause delirium, constipation, and urinary retention. Short half-life benzodiazepines, as previously described, are ideal for isolated anxiety symptoms (e.g., anxiety over a presentation or fear of air travel). If the patient genuinely requires daily benzodiazepines, this indicates that a full syndromal anxiety disorder is probably present and may indicate the need for long-term treatment.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.