The Curbsiders Internal Medicine Podcast #273 ACP 2021: The Highlight Reel Part 2
6 snips
May 10, 2021 AI Snips
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Transcript
Episode notes
Primary Care Carries Most Mental Health Care
- About 80–90% of patients with anxiety and depression are treated in primary care rather than by psychiatrists.
- This makes primary care management skills for these disorders essential for access to care.
Careful SSRI Titration And Short Benzodiazepine Use
- Start SSRIs/SNRIs at about half the typical dose when treating anxiety to avoid early anxiety spikes.
- Use benzodiazepines only short-term for acute symptom relief and plan a taper (≈25% per week).
Prioritize Psychotherapy First
- Use psychotherapy (CBT, problem solving, motivational interviewing) as first-line for anxiety and depression when available.
- Deliver brief behavioral interventions in primary care or refer to online CBT-I/workbooks if access is limited.