BMJ 2011:342:607 – 664 (19th March)

A meta-analysis of treatments for generalised anxiety disorder shows the most effective to be fluoxetine and the most tolerable to be sertraline (at least, this was the one that was least likely to cause patients to drop out of each individual trial).  Neither of these is officially licenced in the UK, so, if your patients insist on something licenced, go for duloxetine or escitalopram for effectiveness (duloxetine was the most likely to induce response but escitalopram the most likely to induce remission, thus being considerably better in the long term), or pregabalin for tolerability.  I suspect the managers of drug budgets will forgive you for going for the non-licenced alternatives.

If you want to reduce your risk of abdominal aortic aneurysm, steer clear of the cigarettes – smoking seems to be the strongest modifiable risk for AAA.  Hypertension is a surprisingly weak risk factor.  Diabetes increases the risk of AAA rupture but, paradoxically, reduces the risk of one forming in the first place.  The UK programme will scan men over 65 years (probably as a one-off, though under review).  Aneurysms less than 5.5 cm can be safely left under observation.

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About Dr Sarah

I'm a GP with a husband and two young children.
This entry was posted in BMJ, Cardiovascular, Psychiatry. Bookmark the permalink.

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