Anxiety_EO Flashcards
What is not recommended for the pharmacological treatment of panic disorder?
Buspirone, propranolol, trazodone and tiagabine
What are first line pharmacological tx of panic disorder? (Total=7)
Citalopram, escitalopram, prozac, paxil, luvox, zoloft and effexor XR
There is evidence that short-term (less than 8 weeks) of adjunctive clonazepam at the initiation of SSRI can lead to a more rapid response
Name some of the second line pharmacological agents used in panic disorder (total=8)
Mirtazapine, lorazepam, clonazepam, diazepam, alprazolam, imipramine and clomipramine and reboxetine
Diagnostic criteria for panic disorder?
Both of the following:
-recurrent unexpected panic attacks
-more than one panic attack followed by more than one month of (1 or both):
Significant maladaptive change in behavior related to the attacks
Persistent concern about additional panic attacks or their consequence
Diagnosis criteria for panic attacks?
Abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and include 4 or more of :
- palpitations
- heat wave or chills
- sweating
- nausea
- dizziness, faint, ligt-headed
- shaking
- depersonalization or derealization
- fear of dying or going crazy
- shortness of breath
- feeling of choking
- chest pain or discomfort
- paresthesia or numbness
DSM criteria for agoraphobia
Fear or anxiety about two or more of the following 5 group situations:
- public transportation (bus, train, plane, ships)
- open space (highway, market place, bridges, parking lots)
- crowd or standing in line
- being outside the home alone in other situations
- being in cinema, theatres, shops
These situations are feared or avoided due to thoughts that escape might be difficult in the event of panic-like symptoms
These situations always provoke fear or anxiety and are actively avoided, endured with maked fear of anxiety or require the presence of a companion
The fear or anxiety is out of proportion to actual danger pose by the situation
Lasts more than 6 months and causes clinically significant distress or functional impairment
What is the treatment of specific phobias?
Exposure-based techniques, including virtual exposure, are highly effective, and are the foundation of treatment for specific phobias. Pharmacotherapy is generally unproven, and thus not recommended.
What are the dx criteria for SAD?
Marked fear or anxiety about social situation
-fear that actions or showing anxiety will result in negative evaluation (humiliation)
-social situation always provokes fear or anxiety and is actively avoided or endured with marked fear or anxiety
-the fear is out of proportion… for more than 6 mo…cause significant distress.
Specify is «performance only»
What are first-line pharmacological treatment for SAD? (Total=6)
Paxil, zolft, effexor xr, pregabaline, escitalopram, luvox
Name not recommended medications for SAD?
Buspirone, propranolol and atenolol (except for prn in performance situations), quetiapine, imipramine, levetiracetam
Name second line tx for SAD?
Citalopram, clonazepam, bromazepam, alprazolam, gabapentin and phenelzine
Name the DSM criteria for GAD?
Excessive worry about a number of events and activities (school, work)
- individual finds it difficult to control the worry
- this worry is associated with at least 3 of the following (restless, muscle tension, irritability, headache, easily fatigues, sleep disturbance, difficulty concentrating) for at least 6 months and causes significant distress…
What are the first line agents for GAD? (Total=7)
Escitalopram, venlafaxine xr, pregabaline, sertraline, paxil, duloxetine, agomelatine
Name second line tx for GAD?
Brupropion XL, quetiapine XR, vortioxetine, imipramine, buspirone, lorazepma, alprazolam, bromazepam, diazepam
Adjunctive therapy 2nd line: pregabaline
Adj thx 3rd line: abilify, olanzapine, risperidone and quetiapine
what is not recommended in GAD?
Ziprasidone as adjunct;
Beta-blockers, tiagabine