Assessing and Treating Patients With Anxiety Disorders

12/29/21, 8:32 PM Psychopharmacologic Approaches to Treatment of Psychopathology

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Generalized Anxiety Disorder Middle-Aged White Male With Anxiety

Decision Point One

Begin Paxil 10 mg po 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

12/29/21, 8:32 PM Psychopharmacologic Approaches to Treatment of Psychopathology

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� 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)

Decision Point Two

No change in drug/dose at this time

RESULTS OF DECISION POINT TWO � Client returns to clinic in four weeks

� Client reports no further decreases in anxiety and is wondering if this means that the medication will not be e�ective for him

Decision Point Three

Increase drug to 75 mg po daily

12/29/21, 8:32 PM Psychopharmacologic Approaches to Treatment of Psychopathology

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Guidance to Student

Increasing the drug to 75 mg po daily would be a prudent next

step. At 4 weeks follow up, the client already demonstrated a

partial response to this medication, so it would be appropriate to

increase to 75 mg po daily. Nothing indicates that augmentation

would be necessary as the client has not had an adequate trial of

this drug at a therapeutic dose (only a starting dose). Similarly,

nothing indicates failure of SSRI therapy and there is no compelling

evidence that switch to an SNRI should occur at this time.

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