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Immediate medical review is advisable if: Anxiety symptoms are severe, persistent, or significantly impair daily activities, work, or relationships Symptoms are accompanied by thoughts of self-harm or suicide Physical symptoms such as chest pain, severe palpitations, or breathing difficulties occur Suspected hypoglycaemia episodes are frequent or severe Gastrointestinal side effects are intolerable or lead to dehydration New or worsening depression accompanies anxiety symptoms For severe symptoms or imminent risk, call 999 or attend A&E

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