Anxiety

Question 1

What are some symptoms of anxiety?

Answer 1

Avoidance
Excessive sweating
Tachycardia
Shortness of breath
Fatigue

Question 2

What is the main inhibitory neurotransmitter?

Answer 2

GABA

Question 3

What are some examples of hypnotics, and what are they used for?

Answer 3

Hypnotics - for insomnia
E.G. zopiclone, or zolpidem (known as Z drugs)

Question 4

What is the 1st line treatment for anxiety?

Answer 4

Selective Serotonin Re-uptake Inhibitors (SSRIs) - escitalopram, paroxetine, sertraline

Question 5

What is an alternative option if SSRIs are not effective?

Answer 5

Serotonin and Noradrenaline Re-uptake Inhibitors (SNRIs) - venlafaxine, duloxetine

Question 6

What are some alternative options if SSRIs and SNRIs are ineffective?

Answer 6

Pregabalin
Benzodiazepines, e.g. diazepam
Propranolol
Buspirone

Question 7

What are the side effects of SSRIs?

Answer 7

Diarrhoea/constipation
GI bleeding
Weight loss
Low libido
Hyponatraemia
Insomnia
Vivid dreams

Question 8

What are some side effects of benzodiazepines?

Answer 8

Sedation - risk of falls
Tremor
Drowsiness
Risk of addiction

Question 9

What are 2 drug classes that should be avoided with SSRIs?

Answer 9

NSAIDs - increased GI bleeding risk
Antiplatelets - risk of bleeding

Question 10

What can abruptly stopping an SSRI cause?

Answer 10

Serotonin syndrome
Doses should hence be titrated

Question 11

What are the symptoms of serotonin syndrome?

Answer 11

Restlessness
Excessive sweating
Agitation
Tachycardia
Muscle rigidity