24365d85ca [new 2011] If sertraline is ineffective, offer an alternative SSRI or a serotonin–noradrenaline reuptake inhibitor (SNRI), taking into account the following factors: Tendency to produce a withdrawal syndrome (especially with paroxetine and venlafaxine) The side-effect profile and the potential for drug interactions The risk of suicide and likelihood of toxicity in overdose (especially with venlafaxine) The person's prior experience of treatment with individual drugs (particularly adherence, effectiveness, side effects, experience of withdrawal syndrome, and the person's preference) [new 2011] If the person cannot tolerate SSRIs or SNRIs, consider offering pregabalin. For other review questions, searches were conducted for the appropriate study design. [2004] People started on antidepressants should be informed about the delay in onset of effect, the time course of treatment, the need to take medication as prescribed, and possible discontinuation/withdrawal symptoms. These can all help people with borderline personality disorder. Thus, clinical practice recommendations are evidence-based, where possible, and, if evidence is not available, informal consensus methods are used. Monitor the person carefully for adverse reactions. 56 p.(Clinical guideline; no. [2004] In addition to being provided with high-quality information, people with panic disorder and their families and carers should be informed of self-help groups and support groups and be encouraged to participate in such programmes where appropriate. Negotiating between the person with GAD and their family or carers about confidentiality and the sharing of information. London (UK): National Institute for Clinical Excellence (NICE); 2004 Dec.
[2004] To facilitate shared decision-making, evidence-based information about treatments should be available and discussion of the possible options should take place. London (UK): National Institute for Health and Clinical Excellence (NICE); 2011 Jan. [2004] Comorbidities The clinician should be alert to the common clinical situation of comorbidity, in particular, panic disorder with depression and panic disorder with substance misuse. 113). Double checking of all excluded studies was not done routinely, but a selection of abstracts was checked to ensure reliability of the sifting. The strength of each recommendation is reflected in the wording of the recommendation, rather than by using labels or symbols. [2004] Common concerns about taking medication, such as fears of addiction, should be addressed. Scoping Searches A broad preliminary search of the literature was undertaken in April 2009 to obtain an overview of the issues likely to be covered by the scope, and to help define key areas. Presentation of Economic Evidence The references to included studies from the economics literature reviewas well as the evidence tables with the characteristics and results of economic studies included in the review, are provided in Appendix 15f of the full version of the original guideline document. In addition, the combination of CBT and sertraline was more effective than either treatment alone.
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