The PMHNP diagnoses a 25-year-old woman with generalized anxiety disorder with panic attacks. Terrified by the panic attacks, she requests medication, saying, “I need something to control them immediately.” The patient is otherwise fit and healthy and has no history of substance abuse or dependence. Which of the following strategies would be reasonable?

Choice A reason: Alprazolam is a short-acting benzodiazepine that carries high risk for dependence. Using it as monotherapy without long-term management is not recommended. Choice B reason: This is the correct answer. SSRIs are first-line long-term treatment for generalized anxiety disorder, and low-dose benzodiazepines such as clonazepam can be used short-term for rapid symptom relief during initiation of SSRIs. This approach balances immediate relief with safe long-term management. Choice C reason: While starting an SSRI alone is reasonable, it may not provide immediate symptom relief, which the patient is requesting. Short-term adjunctive therapy is often needed initially. Choice D reason: Psychotherapy alone is effective but does not meet the patient’s request for rapid symptom control. Combining therapy with pharmacologic treatment is more appropriate in this scenario.