Anxiety Flashcards
Anxiety Disorders
- Specific phobia
- Social Anxiety Disorder
- Panic Disorder
- Agoraphobia
- GAD (Generalized Anxiety Disorder)
Specific Phobia
- Anxiety
- Avoidance of specific object/situation
Social Anxiety Disorder
- Anxiety
- Avoidance of social situations
Panic Disorder
- Repeated unexpected panic attacks
- Concern/avoidance
Agoraphobia
- Anxiety
- Avoidance of crowded/enclosed/open situations
GAD
- Worry anxiety
- Somatic/cognitive/irritability symptoms
Obsessive Compulsive/Related Disorders
- OCD
- Body Dysmorphic Disorder
- Hoarding Disorder
- Trichotillomania
- Excoriation Disorder
OCD
- Obsessive Compulsive Disorder
- Obsessions/compulsions
- Impairment
Body Dysmorphic Disorder
- Preoccupation with perceived bodily flaws
- Repetitive behavior
Hoarding Disorder
- Difficulty discarding possessions due to distress
- Accumulation
Trichotillamania
- Repeated pulling out of hair
- Difficulty stopping
Excoriation Disorder
- Recurrent skin picking
- Difficulty stopping
Trauma/Stressor-Related Disorders
- Acute Stress Disorder
- Post-traumatic Stress Disorder
- Adjustment Disorders
Acute Stress Disorder
- Trauma
- Some PTSD symptoms
- < 1 month
PTSD
- Trauma
- Intrusion
- Avoidance
- Mood disturbance
- Hyperarousal
- > 1 mo
Adjustment Disorder
- Stress
- Significant emotional/behavioral symptoms
- Other disorders not present
Neurophysiology + Anxiety
- Heightened “bottom up”: apprehension, fear and related memory functioning
- Lowered “top down”: cognitive and emotional regulation control of apprehension/fear
Screening Tests
- GAD-7 for anxiety disorders (differing sensitivity/specificity)
- PC-PTSD-5: PTSD
Anxiety Disorder NonPharm
- Cognitive behavioral therapy
- Exposure therapy
- Psychodynamic psychotherapy
- Somatic therapies: exercise, deep brain stimulation
Anxiety Disorder Pharm
- SSRI
- SNRI
- 5HT2 antagonist
- 5HT1A partial agonist
- Multimodal serotonergic agents
- TCA
- MAOI
- Benzos
-CAM: Kava
Serotonin Syndrome
- Difficult to study
- Precipitated by single or multiple serotonergic medications
- D/C med
- Use benzo
- Hypertensive, mydriasis, diarrhea, tremor, agitation
Serotonin Withdrawal Syndrome
- D/C syndrome
- Malaise HA, imbalance, tremors, sleep disturbances, GI disturbances, anxiety
- Reassure or start fluoxetine and taper (less likely to cause)
Pregnancy + Antidepressants
- Spontaneous abortion
- Preterm birth
- Neonatal withdrawal syndrome
- Cardiac malfunctions
- Sertraline and paroxetine minimally excreted in breast milk
Benzos + Pregnancy
- CI
- Excreted in breast milk
- Hypoglycemia, respiratory suppression, neonatal withdrawal, “floppy” infant
No Anti-Panic Property Drugs
- Buspirone
- Propranolol
- Hydroxyzine
Panic Disorder Treatments
- Psychotherapy
- SSRI or SNRI
- Imipramine
- Benzo
Social Anxiety Disorder Treatment
- Psychotherapy
- SSRI or SNRI
- Gabapentin
- Benzo
- MAOI
Acute Stress Treatments
- CHT
- Cognitive Processing Therapy
- Prolonged Exposure Therapy
-Possibly: morphine, hydrocortisone, imipramine
Ineffective for Acute Stress
- SSRI
- Propranolol
- Benzo
PTSD Treatments
- Acute: psychotherapy or medication
- Relapse: Medication
- DON’T USE BENZOS
PTSD Drug Options
- SSRI or SNRI
- Prazosin augmentation
- TCA
- Quetiapine
- Antipsychotic augmentation?
OCD Treatment
- Medications/therapy for acute
- Medications for relapse
- SSRI or SNRI
- Clomipramine
- Augmentation with SDA
Weight Gain Drugs
- Gabapentin
- Amitriptyline
- Mirtazapine
- Olanzapine
- Risperidone
- Quetiapine
- Divalproex
Weight Loss Drugs
- Topiramate
- Bupropion
- Fluoxetine
