Assessing and Treating Clients With Anxiety Disorders

Generalized Anxiety Disorder Middle-Aged White Male With Anxiety

 

Decision Point One

Begin Zoloft 50 mg orally daily

RESULTS OF DECISION POINT ONE

·  Client returns to clinic in four weeks

·  Client informs you that he has no tightness in chest, or shortness of breath

·  Client states that he noticed decreased worries about work over the past 4 or 5 days

·  HAM-A score has decreased to 18 (partial response)

Select what the PMHNP should do next:

Increase dose to 75 mg orally daily

Increase dose to 100 mg orally daily

No change in drug/dose at this time

Generalized Anxiety Disorder Middle-Aged White Male With Anxiety

 

Decision Point One

Begin Tofranil (imipramine) 25 mg orally BID

RESULTS OF DECISION POINT ONE

·  Client returns to clinic in four weeks

·  Client reports a “slight” decrease in symptoms

·  Client's states that he no longer gets chest tightness, but still has occasional episodes of shortness of breath

·  HAM-A score decreased from 26 to 22

Decision Point Two

Select what the PMHNP should do next:

Decision Point Two

Select what the PMHNP should do next:

Increase Tofranil to 50 mg orally BID

Continue current dose and reassess in 4 weeks

Add an augmentation agent such as BuSpar (buspirone) 5 mg orally TID

Generalized Anxiety Disorder Middle-Aged White Male With Anxiety

 

Decision Point One

Begin Buspirone 10 mg orally BID

RESULTS OF DECISION POINT ONE

·  Client returns to clinic in four weeks

·  Client reports slight decrease in symptoms

·  Client states that he still feels very anxious

·  HAM-A score decreased from 26 to 23

· Decision Point Two

· Select what the PMHNP should do next:

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Increase buspirone to 10 mg orally TID

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Increase buspirone to 20 mg orally TID

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Discontinue buspirone and begin Lexapro 10 mg orally daily

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