Anxiety Flashcards
Anxiety and suicide
Higher risk of suicide. 18x risk increase from the average person. Most anxiety disorders substantially increase suicide risk.
How many panic symptoms needed to make the panic attack diagnosis?
4 (lightheaded, sweating, paresthesias, hot/cold flushes, fear of dying or going crazy, derealization/depersonalization, choking, SOB, chest pain, plapitations, nausea).
Which antidepressant is good to use on anxiety when SSRI, SNRI, remeron, bzd have failed?
MAOI, phenelzine.
Good benzo to use for specific phobia (eg, before a flight or test)
Diazepam due to rapid onset. Take 5-10 mg 30 min before.
What pathogen in PANDAS? What is one of the main symptoms?
Group A strepococcus infection . Obsessive or compulsive symptoms.
When you see refusal to go to school, what disorder?
Separation Anxiety disorder . Home schooling is a contraindication because you enable the kid’s avoidance.
Medication for somatic sx disorder and illness anxiety disorder?
SSRI’s, robust support from meta analysis. NNT is 3 for somatic symptom.
What 3 SSRI’s are FDA approved for panic?
sertraline, fluoxetine, and paroxetine.
Which benzos do you give in severe liver disease?
Oxazepam, Temazepam, Lorazepam
What does hyperventiliatoin syndrome look like?
palpitations, arrhythmias, chest pain, paraesthesia to extremities or face, tetany, carpopedal spasm, fear of dying, hallucinations, fatigue, excessive sweating, and dry mouth
Biggest risk factors for panic disorder?
Difficult childhood (physical/sexual abuse)
Treatment for selective mutism
Defocused communication, hierarchal exposure, shaping, and social skills training
GAD: sx present for more than half the days for how many months?
6
Common peaks of panic disorder?
20 and 50 yo
Age of onset of panic disorder
Panic disorder usually has its onset in late adolescene and early adulthood. The median age of onset in the United Staes is 20-24 years. Onset after 45 years of age is uncommon.
Can you give mirtazapine for GAD?
No sir
Insomnia and restlessness in GAD- what drug?
Venlafaxine
What is the earliest age of onset phobia?
fear of blood
Which meds are FDA approved for panic disorder?
Fluoxetine
Paroxetine
Sertraline
Venlafaxine
what 1 symptom can be concerning if everything else looks like a panic attack?
loss of consciousness. If that happens, probably cardiac.
What has been shown helpful in patients who are discontinuing benzodiazepines?
The above case describes a patient with the most likely diagnosis of schizophrenia. γ-aminobutyric acid A receptor subunit α2 (GABRα2) is a marker of GABAnergic neurotransmission during neurodevelopment and is found in high levels in lateral cerebellum of patients with schizophrenia.
Panic disorder peaks when?
Late adolescence and early adulthood. Age 20 and 50 are 2 different peaks of it.
In someone with panic disorder, what other disorder would lead to a poor response to CBT?
Co-occurring adult separation anxiety may be a predictor of a poorer response to cognitive behavioral therapy (CBT) in a patient with panic disorder.
What is hyperventilation syndrome?
Hyperventilation syndrome is caused by excessive breathing beyond metabolic requirement. It is characterized by palpitations, arrhythmias, chest pain, paraesthesia to extremities or face, tetany, carpopedal spasm, fear of dying, hallucinations, fatigue, excessive sweating, and dry mouth. It can be caused due to prolonged anxiety, or it can be caused by organic causes like kidney failure.
Which therapy helps when patients discontinue benzos?
CBT
panic-focused psychodynamic psychotherapy addresses what
addressing transference issues
