Psychotherapy
Reassurance
Self-help and psychoeducation
à Pure self-help, guided self-help, group
psychoeducation
Relaxation therapy
à applied relaxation, progressive
muscle relaxation, deep breathing exercises
Cognitive behavior therapy
Exercise
Pharmacotherapies
Indications of pharmacotherapy
While on psychotherapy, short-term
Psychotherapy ineffective,
Psychotherapies not available
First-line
Selective Serotonin Reuptake Inhibitors
àThese and SNRIs may initially
exacerbate symptoms; a lower starting dose is often required. Fluoxetine and sertraline
are preferred options. Sertraline
is the most tolerable
and cost effective, recommended as first choice by NICE. Fluoxetine
is most effective choice.
Effexor (venlafaxine) SR up to 225 mg/day
Dulan/Duron (duloxetine) up to 60 mg/day
pregabalin 150–600 mg/day
Second-line choices
Agoviz (agomelatine) 25
mg 2 x nocte
Agoviz (agomelatine) 25
mg 4 x nocte
Busron (buspirone) 5 mg
1 x TDS
Steer (buspirone) 10
mg 2 x TDS
Atarax (hydroxyzine) 25
mg 1 x BD
Atarax (hydroxyzine) 25 mg 1+ 1 + 2
Qusel (quetiapine)
Tofranil (imipramine)
Clomixet (clomipramine)
Ramargon (mirtazapine)
Beta-blockers for somatic symptoms, Vortioxetine
2.5–10 mg
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