Case 5 (GAD)

Question 1

What medications are used to treat GAD?

Answer 1

• SSRIs (Sentraline)
• SNRIs (venlafaxine)
• benzodiazepines (diazepam)
• pregabalin
• CBT
• drugs/treatment for underlying conditions (e.g hypothyroidism, substance abuse)

Question 2

What is the MOA of diazepam/benzodiazepines?

Answer 2

Positive allosteric modulation of GABA-A receptors = INCREASES GABA ACTION

Binds to allosteric site on GABA-A
UP-regulates GABA action
= increases chloride transmission
= restores inhibitory action of GABA

Question 3

How long is the maximum time a patient should be on diazepam for?

Answer 3

Up to 2 weeks

highly addictive

Question 4

What is the MOA of SSRIs?

Answer 4

Block SERT = block re-uptake of serotonin back into presynaptic knob

Question 5

What is the MOA of SNRIs?

Answer 5

Block NAT and SERT = block re-uptake of NA and serotonin back into pre-synaptic terminals

Question 6

What is the NICE reccomend course length of CBT?

Answer 6

12-15 hour long sessions of CBT over 4 months

Question 7

What is the MOA of pregabalin?

Answer 7

Increases GABA synaptic concentration

= an anticonvulsant