Anxiety Disorders: Management

Degree of
anxiety disorders
GAD-2 Score Treatment Consultation with expert
Minimal < 3 Relaxation techniques  
Significant ≥ 3

Recommend relaxation

Consider benzodiazepines,
mainly clonazepam or
lorazepam for a short period of time (less than 4 weeks)

Consider antidepressant
treatment with SSRI(i)

Consider psychotherapeutic

  • Cognitive Behavioral
  • Cognitive Behavioral Stress
  • Mindfulness-based Cognitive
  • Peer Support Counseling

Always if treating doctor is unfamiliar with use of antidepressants

If anxiety not responding to treatment

If person has suicidal ideation

In case of complex situations such as drug addiction, personality disorders, acute severe life events

Clinical improvement with antidepressants may take up to 4 weeks;
there is no need to change antidepressants before this time
Dose increment of antidepressant may be considered

Generalized anxiety disorder   Start antidepressant treatment
with SSRI and benzodiazepine
if needed (to reduce anxiety
faster)(i, ii)
Refer to mental health expert to start psychotherapeutic

i See Drug-drug Interactions between Anxiolytics and ARVs
ii Mental health professionals should always be consulted if there is a risk of suicide