1) Mood Disorders
a) Anxiety
i) Generalized Anxiety Disorder
(1) DSM-V Diagnostic Criteria
(a) Excessive anxiety/worry occurring more days than not for ≥ 6 months, about a number of events or activities
(b) Difficult to control the worry
(c) Anxiety & worry are associated with ≥ 3 during the past 6 months
(i) Restlessness
(ii) Easily fatigued
(iii) Difficulty concentrating
(iv) Irritability
(v) Muscle tension
(vi) Sleep disturbance
(d) Sx cause clinically significant distress or impairment in social, occupational, or other areas of functioning
(e) Sx not attributable to the physiological effects of a substance or other medical condition.
(f) Sx not better explained by the symptoms of another mental disorder.
(2) Clinical features
(a) Anxiety …show more content…
These are good first choices because the side effects are not life threatening, are cheap, and because it’s difficult to overdose and cannot cause euphoria.
4. Side effects include GI upset, sexual dysfunction, weight gain, insomnia, and agitation.
5. here can be some withdrawal effects, especially with SSRIs with short half-lives.
6. May cause serotonin syndrome, especially if used with MAOIs.
(ii) TCAs
1. Last line therapy for GAD. Can be used for refractory cases.
2. Imipramine is the first choice for GAD
(iii) Benzodiazepines
1. Last line therapy for GAD. Can be used for refractory cases.
2. Alprazolam, Diazepam, Clonazepam, and Lorazepam are examples. It’s important to note that these are controlled substances and have high abuse potential. It’s also important to note that the long acting agents may cause toxicity, while the short acting agents are even more likely to be abused.
3. Side effects include fatigue, ataxia, anticholinergic effects, memory impairment, peripheral vasodilation, hostility, and addiction/withdrawal
4. These interact with certain drugs, such as alcohol, CNS depressants, antihistamines, and most Benzos are cytochrome inhibitors.
(iv) Hydroxyzine
1. Indicated when other drugs were ineffective or not well tolerated
2. Side effects: anticholinergic
a) Anxiety
i) Generalized Anxiety Disorder
(1) DSM-V Diagnostic Criteria
(a) Excessive anxiety/worry occurring more days than not for ≥ 6 months, about a number of events or activities
(b) Difficult to control the worry
(c) Anxiety & worry are associated with ≥ 3 during the past 6 months
(i) Restlessness
(ii) Easily fatigued
(iii) Difficulty concentrating
(iv) Irritability
(v) Muscle tension
(vi) Sleep disturbance
(d) Sx cause clinically significant distress or impairment in social, occupational, or other areas of functioning
(e) Sx not attributable to the physiological effects of a substance or other medical condition.
(f) Sx not better explained by the symptoms of another mental disorder.
(2) Clinical features
(a) Anxiety …show more content…
These are good first choices because the side effects are not life threatening, are cheap, and because it’s difficult to overdose and cannot cause euphoria.
4. Side effects include GI upset, sexual dysfunction, weight gain, insomnia, and agitation.
5. here can be some withdrawal effects, especially with SSRIs with short half-lives.
6. May cause serotonin syndrome, especially if used with MAOIs.
(ii) TCAs
1. Last line therapy for GAD. Can be used for refractory cases.
2. Imipramine is the first choice for GAD
(iii) Benzodiazepines
1. Last line therapy for GAD. Can be used for refractory cases.
2. Alprazolam, Diazepam, Clonazepam, and Lorazepam are examples. It’s important to note that these are controlled substances and have high abuse potential. It’s also important to note that the long acting agents may cause toxicity, while the short acting agents are even more likely to be abused.
3. Side effects include fatigue, ataxia, anticholinergic effects, memory impairment, peripheral vasodilation, hostility, and addiction/withdrawal
4. These interact with certain drugs, such as alcohol, CNS depressants, antihistamines, and most Benzos are cytochrome inhibitors.
(iv) Hydroxyzine
1. Indicated when other drugs were ineffective or not well tolerated
2. Side effects: anticholinergic