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Drugs & the Brain > Lecture 19- Anxiety and Anxiolytic Drugs > Flashcards

Lecture 19- Anxiety and Anxiolytic Drugs Flashcards

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1
Q

What are the psychological symptoms of anxiety?

A
  • Irritability
  • Minor depressive symptoms
  • Cognitive disturbance
  • Fearful anticipation
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2
Q

What are the physical symptoms of anxiety?

A
  • hyperventillation
  • sympathetic arousal
  • sleep disturbance
  • increased muscle tension
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3
Q

What are the different types of pathological anxiety?

A
  1. General anxiety
  2. Phobias
  3. Panic attacks
  4. OCD
  5. Post-traumatic stress disorder
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4
Q

Describe the two parts of Obsessive compulsive disorder?

A

Obsessions= intrusive/disturbing thoughts.
Compulsions are to try to remove these obsessions e.g. checking, counting
(can just have obsession part)

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5
Q

Gives examples of the compulsions in OCD?

A

Checking, counting, touching and picking.
e.g. dermatillomania= picking at skin.
trichotillomania=hair pulling.

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6
Q

What are the 4 parts of a panic attack?

A
  1. Physiological symptoms
  2. Parasthesiae (tingling)
  3. Detachment from reality
  4. Fear of losing control
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7
Q

What is the diagnostic criteria for panic attacks?

A

sudden onset and underlie a period of intense fear and heightened sympathetic activation. Fear going to die. (easy to confuse symptoms with heart attack or stroke)

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8
Q

What are the treatments for anxiety disorders?

A
  1. Psychological therapy e.g. CBT (time + money)
  2. Drugs:
    a. Beta blockers
    b. Antidepressants
    c. Barbituates
    d. Benzodiacepines
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9
Q

How do barbituates work?

A

Enhance actions of GABA on GABAA receptors.

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10
Q

When are barbituates used?

A

Rarely used for anxiety now because effects.

Used for severe insomnia.

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11
Q

What are the side effects of barbituates?

A
  • Highly addictive
  • High risk of suicide
  • Respiratory depression
  • Tolerance develops quickly
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12
Q

Problems with Benzopdiazepines?

A

-Improvement on barbituates but still a lot of problems.
Addictive, cause dependence, withdrawal can cause anxiety, shakes, dizziness.
Tolerance builds quickly
(usually given in low dose short period of time).

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13
Q

Actions of benzodiazepines?

A
  1. reduce anxiety and aggression
  2. sedate and induce sleep
  3. reduce muscle tone
  4. Anticonvulsant
  5. cause anterograde amnesia
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14
Q

Examples of benzodiazepines?

A
  1. Diazepam (valium)
  2. Chlordiazepoxide (librium)
  3. Nitrazepam (mogadon)
  4. Flunitrazepam (rohypnol)
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15
Q

Benzodiazepines mechanism?

A

Act at GABAA receptor.
Increase opening frequency.
Increase affinity of GABA

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16
Q

Examples of barbituates used?

A 
Thiopental= used in surgery
Phenobarbitone= used in epilepsy
17
Q

Why do barbituates increase suicide?

A

Addictive, cause tolerance and cause respiratory depression so if you take a lot, kill yourself.

18
Q

What happens when diazepam is taken? what does it turn into?

A

Diazepam is turned into Nordazepam. Nordazepam is an active metabolite of diazepam that accumulates. Stays in the plasma for a while, takes a while to leave body.

19
Q

Examples of antidepressants? (SSRIs)

A
  1. Citalopram
  2. Paroxetine (Paxil)
  3. Sertaline
  4. Fluoxetine (Prozac)
20
Q

What are SSRIs?

A

Selective serotonin re-uptake inhibitors.
Antidepressants.
More serotonin staying in the synapse

21
Q

Why are SSRIs not suitable for the acute treatment of panic disorders?

A

They have a marked delay before they become clinically effective. Effective for prophylaxis though. So usually start off taking benzodiazepines or something for a couple of weeks until they kick in.

22
Q

Describe the Paxil scandal?

A

GSK suppressed data on suicide risk and withdrawal symptoms of paxil.
Lots of teenagers committed suicide because it increased their motivation but didn’t help their mood so they had more motivation to kill themselves.

23
Q

When is Buspirone used?

A

Used in general anxiety disorder. Non-sedating, non-drowsy.
Ineffective vs panic attacks.
Not anticonvulsant.

24
Q

How does Buspirone work?

A

5HT1A partial agonist. Inhibitory autoreceptor. This has fast action but anxiolytic effects take weeks.

25
Q

What are the contraindications/interactions with Buspirone?

A 
carbemazepine.
haloperidol
grapefruit juice
liver/kidney dysfunction
asthma
26
Q

Buspirone side effects?

A

nausea, dizziness, headache

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