PG11 Anxiety Spectrum and Related Disorders - Devon Partnership ...

Decision Aid for Specialist Treatment Strategies: Social Anxiety DisorderIntervention Comments Approved foruse in DPT?Augmentation Unlicensed indication for buspironeYof SSRI withbuspironeLimited evidence may be appropriate to consider it insevere/ treatment resistant cases.B-blockers No evidence for efficacy NCitalopramClonazepamEscitalopramFluoxetineMoclobemideParoxetinePhenelzinePregabalinUnlicensed indicationOnly consider if licensed SSRIs intolerable or ineffectiveUnlicensed indication. No evidence of improved efficacyover other benzodiazepines.Insufficient clinical data demonstrating superiority overother available licensed treatments (SSRIs) to justifyadditional prescribing costs associated with treatmentUnlicensed indicationNo evidence to demonstrate efficacyUnlicensed indicationLimited evidence may be appropriate to consider as atreatment option for individuals who have not responded toan adequate trial of at least 2 SSRIs or an SSRI and anSNRI.Licensed for the treatment of social anxiety disorder.Consider if other SSRIs intolerable or ineffectiveAssociated with a higher risk of discontinuation(withdrawal) symptoms following a dose reduction/discontinuation of treatment.Unlicensed indicationLimited evidence may be appropriate to consider as atreatment option for individuals who have not responded toan adequate trial of at least 2 SSRIs or an SSRI and anSNRI.Dietary restrictionsUnlicensed indicationEfficacy reported at higher doses, but evidence insufficientto justify significant increase in prescribing costsassociated with this medicineWhere a prescriber believes it clinically appropriate to consider treatment fora named individual with a non-approved drug, Trust SOP MM26 must be followed.YNNNYYYNReferences:NICE. 2013. Clinical guidelines for Social Anxiety Disorder. Available at: NICE CG159 (Social Anxiety Disorder)2013 [Accessed 29/4/14]British Association for psychopharmacology. Evidence-based pharmacological treatment of anxiety disorders,post-traumatic stress disorder and obsessive-compulsive disorder: A revision of the 2005 guidelines from theBritish Association for Psychopharmacology. Available at: British Association for PsychopharmacologyGuidelines for the treatment of anxiety disorders [Accessed 29/4/14]PG11 – Pharmacological Treatment of Anxiety Spectrum & Related DisordersApproved by Drug and Therapeutics Committee: June 2014Review date: June 2016 Page 13 of 13