Treatment Approaches for GAD

The main treatment approaches for GAD comprise psychotherapy, pharmacotherapy or a combination of both. The often chronic and disabling nature of GAD means that some individuals may fail to respond fully to first-line treatment.  Your patients may require a sequential trial of treatments or possibly the use of combination therapy. Given the chronic nature of […]

Treating Anxiety in the Primary Care Setting: A Case Review

A recent case consultation highlighted medication treatment for an anxiety disorder in the primary care setting. This is a 33 year old male with Generalized Anxiety Disorder and Panic Disorder. He has some benefit from Celexa 40 mg qday, but continues to engage in avoidance behavior, which makes it difficult to sustain work and social […]

Guidelines for Tapering Benzodiazepines

Psychological and physiological dependence on benzodiazepines can occur in as little as two weeks of daily moderate use. It can occur in the most benign of clinical situations, and it is important for providers to be aware of the risk for dependence when prescribing this class of medications. If a patient has been on a […]

Appropriate Use of Benzodiazepines

Millions of prescriptions are written every year for benzodiazepines. In a large percentage of these cases, the provider is uncomfortable with the prescription. For this reason and many others, it is important to have a good understanding of when it might be appropriate to prescribe a benzodiazepine for a patient. This is also becoming particularly […]

Treatment for Anxiety in Children and Adolescents

The presenting symptoms of anxiety in children and adolescents were discussed in last week’s edition and today’s focuses on treatment in pediatric populations.  Primary care pediatric providers can play a major role in diagnosis, treatment planning, prescribing and, as needed, referring for consultation or specialty intervention. Treatment options include therapy or a combination of therapy […]

Assessing and Treating Sleep Disturbance in Patients with Dementia (part 2): Treatment

There are non-pharmacological and pharmacological options to treat sleep disturbance in patients with dementia. Non-pharmacological approaches include: light therapy, regular exercise, and behavioral treatment/sleep hygiene. In general, evening bright light treatment is helpful for sleep maintenance problems and morning light exposure is helpful for patients whose sleep is phase-delayed or who are suffering from a […]

Psychiatric Issues Related to Contraceptives

Contraceptives are commonly used in many forms (oral, patch, injection, etc.) in women of childbearing age, many of who also have psychiatric concerns. It is important to be aware of the interactions between contraceptives and certain psychotropic medications as well as the psychiatric side effects of contraceptives themselves. Contraceptives have synthetic estrogen, progesterone or a […]