Anxiety Flashcards
What medications can cause anxiety?
-anticonvulsants
-antihypertensives
-BRONCHODILATORS
-dopamine agonists (ILLICIT SUBSTANCES)
-STIMULANTS
-LEVOTHYROXINE
What is first line therapy for generalized anxiety disorder(GAD)?
SSRI/SNRI or anticonvulsants
What SSRIs/SNRIs are FDA approved for the treatment of generalized anxiety disorder(GAD)?
escitalopram, sertraline, paroxetine, venlafaxine, and duloxetine
What are the second line treatment options for generalized anxiety disorder?
-benzodiazepines (good efficacy but 2nd line due to SE and dependence)
-Imipramine (TCA)
-bupropion
-vilazodone and vortioxetine
-quetiapine ER
-buspirone
-hydroxyzine (good efficacy PRN)
What are the recommended follow up guidelines for generalized anxiety disorder?
-assess medication tolerability 1-2 weeks after initiation/change of therapy
-assess efficacy ~4 weeks after patient has been on a stable dosage of medication
What is the first line pharmacotherapy for panic disorder?
SSRI/SNRI
Which anxiety disorder is most likely to experience paradoxical increase in symptoms with initiation of SSRI/SNRIs?
Panic disorder
How can paradoxical increase in anxiety symptoms be managed with SSRIs?
Start with lower doses and titrate slowly or benzodiazepines PRN early on in therapy
Way is the best treatment for PTSD?
Psychotherapy
What is first line pharmacotherapy for PTSD?
SSRI/SNRIs
What PTSD symptoms can be relieved with SSRI/SNRIs?
Re-experiencing, avoidance, hyperarousal
What drugs may be used for sleep disturbances in PTSD?
-mirtazapine= sleep/nightmares
-prazosin (anti adrenergic agents)= sleep/nightmares
-trazodone= sleep/nightmares
What is the second line treatment for PTSD?
-anticonvulsants (not monotherapy)
-antipsychotics
In what anxiety disorders are benzodiazepines highly discouraged due to lack of evidence and even worsening of symptoms?
PTSD & OCD
What is the first line treatment for OCD?
SSRIs= fluoxamine