Update To Mental Health Cases
Case Updates
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Changes to Anxiety Management: NICE CKS
Those who have accessed the anxiety section in NICE CKS online recently may have noticed that propranolol has now been removed as a recommendation for use in panic disorder or in anxiety in general. Some of you may have also seen warnings pop up on your computer systems at work highlighting the change of propranolol to ‘Green with specialist initiation’ in anxiety and panic disorder. This is due to the risk if taken as an overdose.
In addition, diazepam maintains a recommendation for use as a short-term adjunct during a crisis. Given that propranolol is falling out of favour, we may find ourselves using diazepam more as a short term adjunct in the future.
The updated NICE CKS guidance can be found using the link here
Consequently, we have updated two of our anxiety cases to reflect this new guidance:
Changes to SSRI / SNRI advice
Due to the ever present risk of increased suicidal ideations when starting SSRI in younger individuals, NICE CKS has updated its guidance for follow-up when initiating treatment. (So far this can only be found on the anxiety management section of their website - link above). The new advice is quoted below:
Advise people aged under 30 years that in a minority of people aged under 30 years, SSRIs and SNRIs are associated with an increased risk of suicidal thinking and self-harm. Anyone in this age group receiving an SSRI or SNRI should therefore be seen within 1 week of first prescribing, and the risk of suicidal thinking and self-harm should be monitored weekly for the first month.
As a result, we have updated our relevant depression cases:
