Excessive, difficult-to-control worry about multiple domains for ≥6 months with somatic arousal symptoms.
Clinical features
- • Persistent worry, restlessness
- • Muscle tension, fatigue
- • Poor sleep and concentration
- • Palpitations, GI upset
Investigations
- • GAD-7 score
- • TFT, ECG if palpitations, consider phaeochromocytoma if paroxysmal
Management
- • Step 1: education and active monitoring
- • Step 2: low-intensity self-help
- • Step 3: CBT or sertraline (SSRI)
- • Step 4: specialist referral; consider pregabalin
- • Avoid benzodiazepines beyond 2–4 weeks
Clinical pearls
- • Caffeine, alcohol and stimulant use frequently maintain symptoms
Related in WardRound
Educational — verify locally.
