CNS part 4 Flashcards
What is the symptoms of GAD
Obsessive and persistent worrying that is hard to control that occurs more days than not for 6 months
Apprehension, irritability, fatigue, headache, GI complaints m, muscle tension
What is the tx for GAD
CBT or pharmacology
How should you determine what SSRI to use for GAD
use side effects rather than published efficacy
What anti anxiety drugs are used
benzos, SSRIs, SNRI, tricyclic antidepressants, buspirone, pregabalin, agomelatine
What can buspirone be used for?
Anxiety
What are the side effects of buspirone
Dizziness, CNS, nausea, diarrhea
What can affect buspirone metabolism
Food can decrease first pass effect
What is the next choice off label med head for anxiety after buspirone?
Gabapentin
What are the AEs of gabapentin
Dizziness, drowsiness, fatigue, peripheral edema, weight gain, constipation, URI symptoms
What patients should use caution with gabapentin?
Substance abuse because it has. Drug dependency
Which med is used off label as an augmentation for SSRI and SNRI
Pragabalin
What are the AEs of pregabalin
Edema, weight gain, dizziness, drowsiness, HA
What are the benzos used as sleep agents
Zaleplon, zolpidem, eszopiclone
What are the two melatonin receptor agonists
Melatonin and ramelteon
What meds are dual orexin receptor antagonists used for sleep
Lemborexant, suvorexant
What are histamine receptor antagonists used for sleep
Doxepin
What is an increased side effect with increased doses of benzos?
Seizure activity
Are benzos more effective for falling asleep or staying asleep?
Falling asleep
What is the most effective Benzo for sleep?
Eszopiclone
Which two benzos are for short term use only
Zaleplon and zolpidem
Which med has the most benefits for patients with sleep onset insomnia
Ramelton
What are the first line meds for panic disorder and agoraphobia
SSRI and SRNI
What are the second line agents for panic disorder and agoraphobia
TCAs, MAOIs, and benzos
What are the preferred meds for OCD treatment
SSRIs, TCAs like clomiprime and SNRI venlafaxine
What is first line TX for specific phobias
CBT exposure therapy
What is first like tx for PTSD
SSRI or SNRI
What med should you start in patients that have only had a partial response to SSRI for GAD
Buspirone
