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Guidelines on 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.

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Guidelines on Anxiety

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  1. Guidelines on Anxiety Dr Jothi Murugan

  2. Prevalence • 5-10%

  3. C/F Apprehension Cued panic attacks Irritability Poor sleeping Avoidance Poor concentration Physical symptoms

  4. Panic disorder with or without agoraphobia • Intermittent episodes of panic or anxiety and taking avoiding action to prevent these feelings

  5. Generalised anxiety disorder • Over-arousal • irritability • poor sleeping • worry about several areas most of the time

  6. Agoraphobia, social phobia or simple phobia • Episodes of anxiety triggered by external stimuli

  7. Recognition and Diagnosis H/o: self medication cultural characteristics Associated depression Substance abuse Medical h/o :Hyperthyroidism

  8. Recognition and Diagnosis • Minimum tests to exclude physical problems • Not usually be admitted • Written info about the condition and support available

  9. 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

  10. Management of panic disorder in primary care • Self help: Exercise, support group, computerised CBT • Refer if trial of 2 treatments don’t work

  11. 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

  12. Generalised anxiety disorder • If after two interventions provided and the person still has significant symptoms, referral to specialist mental health services

  13. Phobia • Agoraphobia, fear of the market place, multiple phobic symptoms and a generalised high level of anxiety. • Specific phobias

  14. Phobia management • CBT • Desensitisation • Diazepam 5-10 mg 2 hours prior to dental procedures

  15. Thank you

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