Managing Expectations of Anxiety Medication and the Role of Tricyclic Antidepressants in GAD

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the treatment of generalized anxiety disorder with Dr. Jared Peck, a Staff Psychiatrist at Mount Sinai Hospital in Toronto.

In this episode, Jordan Bawks (PGY2 resident) and Bruce Fage (PGY4 resident) reunite with Dr. Peck to talk about the bio-psycho-social management of GAD. They cover recommended lifestyle changes for people with GAD, evidence-based pharmacotherapies, including SSRIs, SNRIs, Pregabalin, Quetiapine, TCAs and benzodiazepines, and how to choose between them, and psychotherapeutic treatments with a focus on CBT and a quick overview of some of the third wave cognitive models.

By the end of this episode, the listener will be able to…

1. List the lifestyle changes recommended for people with GAD
2. Describe the first line and second line medication therapies for GAD and the rationale supporting each agent's place in the treatment hierarchy 
3. Appreciate the key elements of CBT that make it effective for the treatment of GAD

Relevant Articles:

• Generoso et al., 2017 (Pregabalin for GAD metaanalysis)
• Katzman et al., 2014 (Canadian Anxiety Guidelines)
• Perrin et al., 2019 (Laval model)

Please Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association or the University of Toronto and are not meant to replace formal clinical education or judgment.

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