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Generalised anxiety disorder

Introduction

Generalised anxiety disorder is characterized by excessive, exaggerated anxiety and worry about everyday life events with no obvious reasons for worry.

Risk Factors

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Signs and symptoms

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Diagnostic criteria

Symptoms include

• Persistent worry
• Disturbances in sleep
• Poor concentration
• Mood disturbances
• Muscle tension
• Tremors

Investigations

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Managemet

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  • Non-pharmacological

    • Psychotherapy
    • Most patients can be treated as outpatients

  • Pharmacological

    Indicated where symptoms are interfering with normal functions of daily living. Where there is concomitant drug/alcohol dependence or co-morbid major depressive episode, an antidepressant may be more appropriate.

    Acute management

    For an acute episode or intense prolonged anxiety:

    • Diazepam 2–5 mg (PO) as a single dose.
    • Repeat if required up to 12 hourly
    • Duration of therapy: up to 2 weeks, taper off to zero within 6 weeks

    Maintenance Therapy

    • Fluoxetine (PO) 10–40mg (PO) daily
    OR
    • Citalopram (PO) 10–40mg (PO) daily
    OR
    • Amitriptyline (PO) 25–75mg daily at night

    • Duration of therapy: variable, although the condition tends to be chronic.
    • Extended medicine treatment should be monitored by a specialist.

    Note:

    • Prolonged treatment with benzodiazepines often leads to tolerance and withdrawal symptoms if the medicine is discontinued abruptly
    • Avoid combining more than one benzodiazepine.

Prevention

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Updated on,

20 Novemba 2020, 07:57:15

References

    1. STG
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