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
12/31/23, 8:14 AM 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
Increase dose to 20 mg po daily
RESULTS OF DECISION POINT TWO � Client returns to clinic in four weeks
� Client reports an even further reduction in his symptoms
� HAM-A score has now decreased to 10. At this point- continue current dose (61% reduction in symptoms)
Decision Point Three
Maintain current dose
12/31/23, 8:14 AM Psychopharmacologic Approaches to Treatment of Psychopathology
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Guidance to Student
At this point, it may be appropriate to continue client at the current
dose. It is clear that the client is having a good response (as
evidenced by greater than a 50% reduction in symptoms) and the
client is currently not experiencing any side e�ects, the current
dose can be maintained for 12 weeks to evaluate full e�ect of drug.
Increasing drug at this point may yield a further decrease in
symptoms, but may also increase the risk of side e�ects. This is a
decision that you should discuss with the client. Nothing in the
client’s case tells us that we should consider adding an
augmentation agent at this point as the client is demonstrating
response to the drug. Avoid polypharmacy unless symptoms
cannot be managed by a single drug.
Start Over (index.html)
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