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1. Consider starting or switching to one of the following medications approved by Health Canada* for the anxiety disorders, PTSD and OCD:
| Medication | Generalized anxiety disorder | Social anxiety disorder | Panic disorder | Post-traumatic stress disorder | Obsessive-compulsive disorder |
| Citalopram | |||||
| Escitalopram | X | X | |||
| Fluoxetine | X | ||||
| Fluvoxamine | X | ||||
| Paroxetine | X | X | X | X | X |
| Sertraline | X | X | X | X | |
| Duloxetine | X | ||||
| Venlafaxine | X | X | X |
*Note that these medications are approved based on having been studied for these disorders. It is likely the benefits of SSRIs and SNRIs represent a class effect for these conditions.
2. Additional considerations in medication selection:
- Has the patient had a particular response to a certain antidepressant in the past?
Has there been a family history of response to a certain antidepressant?
Is the patient on multiple medications? Consider…
Is there chronic pain? Consider…
Is there cardiovascular illness? Consider…
Is the patient a child/youth (age < 18)? Consider…
Is the patient in the perinatal period? Consider…
- Sertraline (Zoloft)
- For more information, visit MotherToBaby
Is cost an issue? If so, then consider these less costly medications…
Patient preference
Consider pregabalin for patients with GAD and social anxiety disorder unable to tolerate or have not responded to SSRIs or SNRIs