3.1 Anxiety
Anxiolytics
See NICE CG113 Generalised anxiety disorder and panic disorder in adults: management
See NICE CG 159 Social anxiety disorder: recognition, assessment and treatment
| Anxiolytics | Preparations | Comments |
| Buspirone† | 5mg and 10mg tablets | May take up to 2 weeks to see response. More costly than benzodiazepines. |
| Chlordiazepoxide hydrochloride | 5mg and 10mg tablets | Used as an adjunct in acute alcohol withdrawal. See section 4.10.1 |
| Diazepam | 2mg and 5mg tablets 2mg/5ml oral solution |
|
| Lorazepam | 1mg tablets 4mg/ml injection |
Injection for HPFT prescribing only |
| Oxazepam | 10mg and 15mg tablets | Preferred choice in hepatic impairment. |
| Pregabalin | 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg and 300mg capsules | Approved for use in line with NICE CG 113 as a treatment option at STEP 4 in the management of generalised anxiety disorder (GAD). To be initiated in secondary care, and then continued in primary care. NOT approved for neuropathic pain in Hertfordshire. See section 4.8 for use in epilepsy. Flat pricing structure - prescribe lowest number of capsules to achieve required dose. eg 100mg tds is 33% more costly than 150mg bd |
| Duloxetine | 30mg and 60mg capsules | Approved for use in line with NICE CG 113 as a treatment option at STEP 4 in the management of generalised anxiety disorder (GAD). To be initiated in secondary care and then continued in primary care. See also section 4.3.4 for restricted use in depression. Note: 20mg and 40mg strengths (marketed as Yentreve®) are not licensed for depression. |
| Propranolol | 10mg and 40mg tablets | Beta-blocker - for managing physical signs of anxiety. See BNF chapter 2 section 4.1 for drug monograph. |
† - denotes a less preferred choice of medicine.
Continue to 3.2 Attention deficit hyperactivity disorder