Module 3: Anxiolytics & Hypnotics

Question 1

Anatomical localization of fear

Answer 1

basolateral, central, and medial nuclei of amygdala

Question 2

Anatomical localization of anxiety

Answer 2

basolateral amygdala projections to bed nucleus of stria terminalis

Question 3

Two drugs approved by FDA for panic disorder

Answer 3

Alprazolam (Xanax)

paroxetine (Paxil)

Question 4

Approved for GAD and useful in panic disorder combined with depression

Answer 4

Venlafaxine (Effexor)

Question 5

First-line treatment for OCD

Answer 5

SSRIs - 
Prozac 
Zoloft
Luvox
Paxil

Question 6

Therapy techniques for OCD

Answer 6

Thought stopping

Saturation therapy

Question 7

First-line treatment for PTSD

Answer 7

Zoloft

Paxil

Question 8

A second consideration for PTSD

Answer 8

Buspar

Question 9

What two TCAs have been shown to be effective in PTSD

Answer 9

Imipramine (Tofranil)

amitriptyline (Elavil)

Question 10

How long should a trial of TCAs go on for treatment of PTSD?

Answer 10

8 weeks

Question 11

Used as a first-line treatment for nightmares associated with PTSD

Answer 11

Prazosin (MiniPress)

Alpha-1 adrenergic blocker

Question 12

Affect of Prazosin to decrease nightmares

Answer 12

Blocks adrenaline

Question 13

Acts as agonist on benzodiazepine site of the GABA-a receptor

Answer 13

Zolpidem (Ambien)

Eszopiclone (Lunesta)

Question 14

Approved for long-term use of anxiety

Answer 14

Lunesta

Question 15

first-line treatment for most anxiety disorders

Answer 15

SSRIs

Question 16

An azapirone effective in the treatment of GAD

Answer 16

Buspirone (BuSpar)

Question 17

Used for performance anxiety or social anxiety

Answer 17

Beta blockers (Propranolol)

Question 18

symptoms of GAD

Answer 18

Concentration, fatigue, arousal, muscle tension, irritability, sleep

Question 19

symptoms of panic disorder

Answer 19

phobic avoidance, unexpected panic attacks

Question 20

symptoms of Social Anxiety Disorder

Answer 20

Phobic avoidance/behavior change, expected panic attacks

Question 21

symptoms of PTSD

Answer 21

sleep, arousal, avoidance

Question 22

Fear center in the brain

Answer 22

amygdala

Question 23

core symptoms of anxiety disorders

Answer 23

Fear, Worry

Question 24

Worry loop in the brain

Answer 24

Cortico-striato-thalamo-cortical circuit

Question 25

avoidance pathway in brain (motor responses)

Answer 25

periaqueductal gray area (PAG)
fight/flight
freeze

Question 26

pathway of fear response in the brain

Answer 26

amygdala to

Anterior cingulate cortex (ACC) and Orbitofrontal cortex (OFC)

Question 27

endocrine output of fear pathway in the brain

Answer 27

amygdala to hypothalamus

Question 28

CYP enzymes in psychiatry

Answer 28

1A2
2D6
3A4
2C19 (sometimes)

Question 29

Respiratory pathway in the brain in response to fear

Answer 29

amygdala to Parabrachial nucleus

Question 30

Symptoms of respiratory response to fear

Answer 30

Increase respiratory rate, shortness of breath, asthma