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Home Formulary 4.0 Central Nervous System 4.3 Antidepressant drugs 4.3.2 Antidepressants for the treatment of anxiety disorders* 4.3.2.1 Generalised anxiety disorder (GAD), social anxiety disorder

4.3.2.1 Generalised anxiety disorder (GAD), social anxiety disorder

ChoiceDrugDosage
1st choiceNon-pharmacological treatment
2nd choiceSertraline tablets 50mg, 100mg [GAD unlicensed indication]Dose:
Initially 25mg (half a tablet) daily for one week, then increased to 50mg daily, then increased in steps of 50mg at intervals of at least 1 week if required, increase only if response is partial and if drug is tolerated; maximum 200mg per day.

Prescribing Notes

  • Refer to NICE CG113 Generalised Anxiety Disorder and Panic Disorder
  • Before starting antidepressants refer to NICE NG215 for information that should be considered and discussed with the patient, including steps to reduce the risk of dependence or withdrawal symptoms
  • GAD should be distinguished from acute anxiety state. Treatment options include psychological, pharmacological and self-help approaches
  • NICE state: Do not offer a benzodiazepine for the treatment of GAD in primary or secondary care except as a short term measure during crises
  • There is insufficient evidence to support the routine use of beta blockers in the treatment of GAD, see the Stop and Limited Evidence List
  • Refer to NICE GG159 for the management of Social Anxiety Disorder

Cautions

See section 4.3.1

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