Anxiety treatment for Pompano Beach — SSRI dosing done right, CBT that works.

RECO Integrated Psychiatry sits 18 miles north of Pompano Beach on I-95, a 28-minute drive to the Delray Beach office. The anxiety program is built around accurate DSM-5-TR diagnosis (GAD-7, PDSS, LSAS, Y-BOCS at intake), SSRI dosing at the anxiety-appropriate upper end rather than the depression starter dose, and structured referral to exposure-based CBT or ERP. Benzodiazepines are used narrowly, with a taper plan defined at prescription. In-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS.

From most Pompano Beach addresses, RECO Integrated Psychiatry’s Delray Beach office sits 18 miles north on I-95 — a 28-minute drive off-peak that keeps specialist-level psychiatric care inside the same South Florida corridor. For adults in Cresthaven, Lighthouse Point, Sea Ranch Lakes, and Hillsboro Shores, that distance is often clinically useful: enough separation from the daily scene to think about treatment without leaving the region. The outpatient program is built around three things that primary care visits routinely miss in anxiety care — accurate DSM-5-TR diagnosis, correct SSRI dosing, and structured referral to exposure-based psychotherapy.

Naming the disorder before treating it

“Anxiety” is a wide word. Generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and obsessive-compulsive disorder (OCD) all present with anxious distress, but they respond to different therapy protocols and often to different medication dosing. Casual conversation collapses them; many primary care visits collapse them too, which is how a client ends up on 50 mg of sertraline for OCD and told the medication didn’t work.

Intake at RECO uses structured measures to distinguish them: GAD-7 for generalized worry, the Panic Disorder Severity Scale (PDSS) for uncued panic and anticipatory anxiety, the Liebowitz Social Anxiety Scale (LSAS) for social and performance domains, and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) for obsessions and compulsions. The intake note names a DSM-5-TR primary diagnosis rather than a vague “anxiety, unspecified,” because the primary diagnosis determines the therapy referral. Panic disorder wants interoceptive exposure; OCD wants exposure and response prevention (ERP); social anxiety wants in-vivo exposure with cognitive restructuring; GAD wants worry postponement and metacognitive work.

Comorbid anxiety disorders are the rule rather than the exception. When two or three are present, the plan sequences them by severity and functional impact rather than treating everything at once. A client with OCD driving hours of daily rituals and mild social anxiety gets ERP-first sequencing; the social piece is worked once the ritual burden drops.

SSRI dosing for anxiety versus depression

Effective SSRI doses for anxiety disorders typically sit at the upper end of the depression range. Sertraline for GAD or OCD frequently requires 150-200 mg to reach full response; escitalopram commonly runs at 20 mg; paroxetine 40-60 mg. Underdosing is one of the more common failure points in outpatient anxiety treatment — clients get labeled medication-resistant when they were never trialed at an anxiety-appropriate dose for an anxiety-appropriate duration.

Anxious clients are also often started at half the usual starting dose, because SSRI activation on initiation can transiently worsen anxiety before it improves. Sertraline may begin at 25 mg for a week; escitalopram at 5 mg. Titration is slower, sometimes stepping every two to four weeks rather than weekly. The target dose window is higher, and the trial duration required to call a medication a failure is longer — 8 to 12 weeks at therapeutic dose, not 4 weeks at a starter dose.

Response is tracked with the same instruments used at intake — GAD-7 and Y-BOCS at each visit — so titration decisions rest on measured change rather than global impression alone.

Augmentation and second-line strategy

Partial responders in GAD are often augmented with buspirone at 20-60 mg per day rather than switched off the SSRI. Buspirone lacks abuse potential and does not interfere with exposure-based CBT extinction learning. For panic disorder partial responders, the evidence favors adding CBT with interoceptive exposure over stacking additional medications — the somatic sensitivity that drives panic is more reliably reduced by structured exposure than by another prescription.

OCD is the disorder where augmentation looks different from the rest of anxiety care. Partial responders on an adequate SSRI trial are augmented with low-dose antipsychotics — aripiprazole at 5-15 mg or risperidone at 0.5-2 mg. The evidence base for antipsychotic augmentation in OCD is stronger than for switching to an SNRI, which is often the reflex move in primary care. That distinction matters for a client who has cycled through three SSRIs and been told they are treatment-resistant.

Beta-blockers have a narrow but real role in situational performance anxiety — propranolol 10-40 mg an hour before an anticipated event blunts tachycardia and tremor without sedating cognition. For PRN anxiolysis without benzodiazepine risk, hydroxyzine 25-50 mg and gabapentin 300-600 mg are the more defensible options.

Benzodiazepines — the practice’s position

Benzodiazepines have a real but narrow place. Short-term crisis management — a suicidal patient waiting for an SSRI to take effect, an acute panic exacerbation while CBT is being scheduled — is a defensible indication. So is a subset of chronic panic disorder that has failed adequate SSRI trials and CBT with interoceptive exposure. Beyond those, the default at RECO is not to prescribe long-term.

The reasons are clinical rather than ideological. Benzodiazepines blunt fear extinction learning, which is the mechanism CBT and ERP rely on — meaning a client taking clonazepam through their exposure protocol often does not consolidate the therapy gains. Chronic use also carries cognitive slowing, tolerance, and dependence liabilities that are difficult to reverse in older adults. For clients with any personal or family history of substance use disorder, the default is off.

When a benzodiazepine is prescribed, the plan is explicit at the outset: a taper timeline, defined non-benzodiazepine alternatives (hydroxyzine, gabapentin, propranolol, buspirone), and a therapy referral. Open-ended maintenance without a review point is not offered.

What to expect at the initial evaluation

The intake runs 60-75 minutes with a psychiatrist. The visit covers current symptoms with structured measures — GAD-7, PDSS, LSAS, or Y-BOCS as clinically indicated — plus a full medication history including partial trials and dose ceilings, a substance use screen, medical comorbidities, and family psychiatric history. Sleep, caffeine, and alcohol intake are covered explicitly; all three commonly drive symptoms attributed to primary anxiety.

Clients leave the first visit with a working DSM-5-TR diagnosis, a written medication plan (start dose, titration schedule, expected trial length), a referral to disorder-appropriate CBT or ERP, and a follow-up scheduled two to four weeks out. When anxiety treatment requires a psychotherapy protocol not delivered in-house, the referral goes to a vetted community clinician with the relevant training rather than a generic therapy list.

Insurance and getting to Delray Beach from Pompano

RECO Integrated Psychiatry is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS plans. The admissions team runs the benefits check before the first visit so the copay, deductible position, and any prior authorization requirement for TMS or Spravato are known in advance rather than surfaced at billing.

From most Pompano Beach addresses, the office is 18 miles up I-95, exiting at Atlantic Avenue in Delray Beach — about 28 minutes off-peak, closer to 40 during rush. Telepsychiatry is available for follow-up medication management once the in-person evaluation is complete, which most Pompano clients use to cut drive frequency after the first two or three visits.

Serving residents of: Cresthaven, Lighthouse Point, Sea Ranch Lakes, Hillsboro Shores.