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29 Cards in this Set

  • Front
  • Back
treatment for mild GAD and moderate-severe GAD
mod-sev=psych + pharmacotherapy
non-pharmacological therapy for anxiety d/o
-avoid caffeine, drugs of abuse, stimulants
-relaxation therapy
acute pharmacotherapy
long-term pharmacotherapy
-buspirone (2nd line)
BZD properties and which are tolerance dependent
-sedative (T)
-anticonvulsant (T)
-muscle relaxant (T)
lipophilic BZDs
chlorazepate, diazepam
less lipophilic BZDs
lorazepam, oxazepam
agents that are recommended for use in elderly patients & patients having hepatic dysfunction
-temazepam, lorazepam, oxazepam (conjugated only, don't undergo hepatic oxidation)
BZD C/I (5)
-alcohol intox
-chronic pulm insufficiency
-sig hepatic dz
-sleep apnea
-comorbid substance use d/o
BZD w/drawal sxs
-muscle tension
Buspirone MOA
5-HT1a partial agonist
buspirone advantages
-no abuse potential
-no sedation or impairment of motor activity
buspirone d/advantages
-long onset of effect
-no cross tol w/ BZDs
-previous users of BZDs may not think they respond as well
buspirone onset of effect
at least 1 month
Panic d/o 1st line agents + OOA
SSRIs, antipanic effect usually seen in 4-6wks, but may take up to 12wks
1st line agents in patients requiring rapid relief of anticipatory anxiety and patients who are unable to tolerate antidepressants; OOA
BZDs, antipanic effects usually seen w/in 1 wk
Other agents for panic d/o
-selected TCAs (imipramine, clomipramine)
SSRI starting dose
1/4-1/2 recommended starting dose
alprazolam recommended initial dose and antipanic dose
-0.25mg-0.5mg tid
-4-10mg daily in DD
clonazepam initial dose and antipanic dose
-0.25mg bid
-3-6mg in DD
guidelines suggest treatment should not be d/c in patients having: (3)
-severe panic d/o
-hx of severe relapse
-high levels of current stress
OCD 1st line agents
OCD 2nd line agent
clomipramine (selected after 2-3 failed SSRIs)
post-traumatic stress d/o (PTSD) 1st line agents
PTSD 2nd line agents
venlafaxine, mirtazapine
these agents may decrease anger and aggression related to PTSD
mood stabilizers
these agents may decrease nightmares and improve sleep in PTSD
antiadrenergics (alpha1 blockers)
SAD 1st line agents
SAD other agents
-propanolol prn 1-2hrs before a presentation or performance