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NeuroPsych > Anxiety > Flashcards

Anxiety Flashcards

1
Q

Who is most at risk of anxiety?

A

Women
Whites
30-40s

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2
Q

Anxiety Rating Scales

A

HAM-A
SAS
STAI

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3
Q

GAD Dx Criteria

A

General anxiety for >6 months + 3 of 6 other sx (fatigue, restless, irritable, pain etc)
Distress/impairment

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4
Q

First Line Treatment of GAD

A

SSRIs - start at 1/2 dose to avoid rebound anxiety

Reassess after 4 week trial

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5
Q

SSRI Side Effects

A

GI upset - goes away
Loss of libido
Weight gain
SR Syndrome

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6
Q

Which SNRIs are first line for GAD?

A

Duloxetine and Effexor XR

Hi doses = NE activity

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7
Q

Second Line GAD

A 
TCAs
BZDs
Buspirone
Lyrica
Vistaril
Benadryl
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8
Q

TCA Side Effect Profile

A

Cardiac complications
Suicide
Anti-Ach effects!

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9
Q

BZDs in GAD

A

Not recommended as mono therapy - dependence/tolerance

Require GABA to be bound, to have effect!

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10
Q

Which BZDs have active metabolites?

A

Chlordiazepoxide - oldest

Diazepam

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11
Q

Which BZD has the worst withdrawal effects?

A

Oxazepam

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12
Q

Which BZDs can be given in hepatic dysfunction?

A

Lorazepam
Oxazepam
Temazepam
Not metabolized by p450s!

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13
Q

Short and Long Term Considerations in BZDs in GAD

A

Short - rebound anxiety

Long - amnesia, dependence

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14
Q

Stopping BZDs

A

Taper by 10% every 2-3 weeks and monitor for GAD/withdrawal sx

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15
Q

Buspirone

A

SR autoreceptor blockers

Onset 4-6 weeks

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16
Q

Lyrica in GAD

A

Basically 3rd line because not a thing

Not robust enough evidence

17
Q

Anti-His in GAD

A

Sedation purposes only
NOT for severe GAD
PRN/adjunct

18
Q

Panic Disorder w/o Agoraphobia Dx Criteria

A

Panic attacks + 1+ months of worrying about attacks (future occurrences, implications, ∆behavior)

19
Q

PD w/ Agoraphobia Dx Criteria

A

Panic attacks + 1+ months of worrying about attacks (future occurrences, implications, ∆behavior)
PLUS
Anxiety of being in place where escape is impossible/embarrassing - avoided or endured w/ distress

20
Q

Who had PD commonly?

A

Women
MDD
Alcohol Dependence

21
Q

Which SSRIs have the worst d/c syndrome?

A

Paroxetine
Cymbalta
Effexor

22
Q

Panic Disorder First Line

23
Q

Panic Disorder Second Line

A

SNRIs - effexor XR only (IR - somatic sx, anxiety issues)
BZDs
TCAs

24
Q

Social Phobia

A

INTENSE fear of social/performance sitch - humiliation/embarrassment
Insight
If 6 months

25
Q

Social Phobia Treatment

A

SSRIs - not Paxil even though it was the first one to be approved by FDA
Effexor XR (2nd line)
BZDs - adjunct to SSRIs
Propranolol

NeuroPsych (13 decks)

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