Anxiety

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

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