| Choice | Drug | Dosage |
|---|---|---|
| 1st choice | Non –pharmacological treatment | |
| 2nd choices | Citalopram tablets 10mg, 20mg, 40mg | Dose: Initially 10mg daily, increased gradually if necessary in steps of 10mg daily, usual dose 20-30mg daily; max 40mg daily (elderly over 65 years, max 20mg daily) |
| Or | ||
| Sertraline tablets 50mg, 100mg | Dose: Initially 25mg (half a tablet) daily, increased after one week to 50mg daily; if response is partial and if drug tolerated, dose increased in steps of 50mg at intervals of at least one week to max 200mg daily | |
Prescribing Notes
- Refer to NICE CG113 Generalised Anxiety Disorder and Panic Disorder
- Treatment options include psychological, pharmacological and self-help approaches
- In panic disorder, symptoms frequently get worse before they get better after starting a SSRI
- Most patients will require a SSRI for 6–12 months before the gradual discontinuation of treatment
Cautions
See section 4.3.1