Nice has updated its guidance on managing generalised anxiety disorder. Â Benzodiazepines should not be offered as treatment for generalised anxiety disorder (except as short term crisis help), and nor should antipsychotics in primary care. It says sertraline can be considered, but that as of January 2011, it did not have UK marketing authorisation for this indication so documented informed consent is needed.
The guidance stresses the importance of considering each person’s needs and preferences, and on good communication. The first step should be education about the disorder and active monitoring, followed by low-intensity psychological intervention such as guided self-help. After that, the choice is between more intensive psychological intervention or drug treatment. A final layer consists ofÂ more complex and intensive specialist interventions. Recommendations for panic disorder, also included in this guideline, have not changed.