Anxiety: spectrum from response to a crisis → adjustment disorder → major anxiety disorder.
Ensure anxiety not secondary to poor symptom control, especially pain or dyspnea.
Delirium can present with anxiety-like symptoms.
Drugs
Antidepressants
- see section on depression management
Benzodiazepines
- for moderate to severe ongoing anxiety: clonazepam
- for acute short-acting anxiety/panic (temporary use until antidepressant onsets): lorazepam
- in frail older adults: methotrimeprazine may be better than benzodiazepine
Other therapies
- recommend supportive psychological and spiritual counselling
- discussing and providing information about disease-progression and the dying process may relieve specific anxieties
- avoid anxiety triggers