Anxiety Disorders: Management

Degree of
anxiety disorders
GAD-2 Score Treatment Consultation with expert
Minimal < 3 Relaxation techniques  
Significant ≥ 3
  • Recommend relaxation
    techniques
  • Consider benzodiazepines,
    mainly clonazepam or
    lorazepam for a short period
    of time (less than 4 weeks)
  • Consider antidepressant
    treatment with SSRI(i)
  • Consider psychotherapeutic
    intervention:
    • Cognitive Behavioral
      Therapy
    • Cognitive Behavioral Stress
      Management
    • Mindfulness-based Cognitive
      Therapy
    • Peer Support Counseling
  • Always if treating doctor is unfamiliar with use of antidepressants
  • If depression not responding to treatment
  • If person has suicidal ideation
  • In case of complex situations such as drug addiction, anxiety disorders, personality disorders, dementia, 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
intervention
 

i See Drug-drug Interactions between Anxiolytics and ARVs

ii Mental health professionals should always be consulted if there is a risk of suicide