Anxiety disorder

• Anxiety disorder is common. GPs encounter patients with anxiety disorders everyday, so it is important to have some basic understanding of the disorder and also management plans

• Anxiety disorders include: general anxiety disorder, phobias, OCD, PTSDs, panic attack, substance induced anxiety and anxiety secondary to general medical condition

• My personal approach is that I do not prescribe benzodiazepam to anyone who comes in with anxiety disorder. As it is often lifelong and most patients ended up becoming dependent on benzodiazepam. I will usually bring this straight up during the first consultation, which prevents them from coming in for benzodiazepam prescription in the future

• Use DASS 21 or K10 to assess level of distress 

• Substance abuse or comorbid psychiatric disorders are common in this population, make sure you screen for them 

• Management plan
• Avoid benzodiazepam. You are not doing the patient any good by prescribing them. 
• Psychoeducation 
• It is the key to many psychological condition 
• use the flight/fight model to explain the purpose of anxiety
• Cognitive behavioural therapy
• Essential to mention this in the exam 
• Do a mental health plan and refer to psychologist 
• National e-therapy centre for anxiety
• Medications
• Some SSRIs have anti anxiety effect but only escitalopram is currently listed to use in GAD 
• Avoid Paroxetine in young women who have not completed their family

   

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