Anxiety Disorder (GAD): A Case Study

Since the Wellbutrin XL had intolerable side effects for J.D. she was switched to 30 milligrams of Cymbalta (duloxetine hydrochloride) delayed release, an atypical antidepressant, once a day. This dosage is within normal prescribing range (Preston et al, 2013). Duloxetine hydrochloride has the added benefit of being prescribed for pain as well as GAD (Brown University, 2014), which was important since J.D. suffers significant pain due to the degenerative disc disease in her back and anxiety symptoms, though she is not diagnosed with an anxiety disorder. This medication is in the class of a serotonin and norepinephrine reuptake inhibitor antidepressants. As the name suggests, duloxetine hydrochloride inhibits reuptake of serotonin and norepinephrine, increasing these neurotransmitters in the central nervous system (Formulary, 2004). While it works on these neurotransmitters, it has little effect on histamine-1, norepinephrine A1, 5-TH1A and 5-HT1B, 5-HT1D, D2, and other …show more content…
is still taking it though bupropion was discontinued. Ropinirole is a non-ergoline dopamine agonist that is a common antiparkinsonian drug that is also indicated for restless leg syndrome. It acts directly on the postsynaptic striatal receptors, allowing for more dopamine to be in the synaptic cleft by reducing turnover of the neurotransmitter (Murdoch, Cheer, & Wagstaff, 2004). Ropinirole focuses mostly on stimulating D2 and D3 receptors with little activity on other receptors, leading to fewer side effects (Murdoch et al., 2004). The most common side effects include nausea, dizziness, headache, constipation, abdominal pain or discomfort, and drowsiness (U.S. Food and Drug Administration, 2008). It is unclear whether J.D. will continue on this medication now that she is no longer on the bupropion and it is something that will be explored with her