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Table 1 Patient presentation and treatment timeline

From: Substance-induced anxiety disorder after one dose of 3,4-methylenedioxymethamphetamine: a case report

Day 0 Patient reports having ingested MDMA
Day 3 Development of acute anxiety and physiological arousal
Day 9 Patient presents to clinic for evaluation and is prescribed uptitration of buspirone
Week 2 Patient is prescribed lorazepam
Week 3 Patient is taking full dose of buspirone with no significant improvement in anxiety; rare lorazepam use
Prescribed SSRI but does not start taking
First visit with behavioral health consultant, total of six visits every 1–4 weeks
Week 4 Seen by psychiatrist and given tentative diagnosis of substance-induced anxiety disorder
SSRI recommended
Week 6 Begins SSRI sertraline and begins buspirone taper
Week 7 Reports some improvement in anxiety and sleep
Week 7.5 Reports acute worsening of anxiety with suicidal ideation
Sertraline dose is lowered, and in 3 days, patient no longer has suicidal ideation 
Weeks 8–10 Continues sertraline, reaching dose of 50 mg once daily with continued improvement in anxiety
Weeks 10+ Seen by psychiatrist 2, who concurs with diagnosis of substance-induced anxiety disorder
Patient continues sertraline 50 mg/day for several more months without resurgence of anxiety symptoms
  1. MDMA 3,4-Methylenedioxymethamphetamine, SSRI Selective serotonin reuptake inhibitor