Management of Depression and Anxiety

Pharmacotherapy

• The American College of Physicians recommends escitalopram at a dose of 20 mg daily for optimal management of depression, anxiety, and PTSD symptoms, as evidenced by clinical trials 1
• Hydroxyzine 25 mg as needed is appropriate for acute anxiety management, providing symptom relief while waiting for the full effect of the SSRI 3

Psychotherapy

• The American Psychological Association recommends initiating structured cognitive behavioral therapy (CBT) for 12-14 sessions over approximately 3-4 months, which is particularly effective for social anxiety and PTSD symptoms 5
• Combination of CBT and SSRI shows better outcomes than either treatment alone, according to the Journal of the American Academy of Child and Adolescent Psychiatry 6

Lifestyle Recommendations

• The National Institute on Alcohol Abuse and Alcoholism recommends avoiding alcohol consumption, as it can worsen depression and anxiety symptoms and reduce medication efficacy 2
• Regular physical activity is recommended, as exercise has been shown to improve both depression and anxiety symptoms, and can be used as an adjunctive treatment alongside medication and therapy 4