A 35-year-old woman has persistent worry about many things, muscle tension and poor sleep for 8 months. What is the NICE-recommended first-line approach?
Answer and explanation
Correct answer: A. Psychological therapy such as CBT or an SSRI, with benzodiazepines avoided long term
- Step 1: This is generalised anxiety disorder.
- Step 2: NICE recommends CBT, applied relaxation or an SSRI such as sertraline, with benzodiazepines only for short-term crisis.
Answer
Psychological therapy such as CBT or an SSRI, with benzodiazepines avoided long term.
Why not the others: Long-term diazepam prescribed for at least a year to keep her anxiety controlled: Benzodiazepines cause dependence and are limited to 2 to 4 weeks. Antipsychotic medication as first-line treatment, with a review in six months: Antipsychotics are not first-line. Regular alcohol in the evenings as a means of relaxing and sleeping better: Alcohol worsens anxiety.
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