Week 9 - Anxiety Disorders Flashcards
When does anxiety become a disorder?
When feelings of tension and anxiety persist for most days for 6 months or more
There is not a proportional threat or stressor
Excessive fear and anxiety
Behavioural disturbances
Physical symptoms
What are the different types of anxiety disorders?
Generalised anxiety disorder
Panic disorder
Social anxiety disorder
Specific phobia
Separation anxiety disorder
Selective mutism
Agoraphobia
What are some treatments for anxiety disorders?
Psychotherapy
CBT
Medications
Healthy lifestyle
What are some medications for anxiety disorders?
Anti-depressants (SSRI and SNRI)
Benzodiazepines
Beta-blockers
What are some risks associated with anxiety?
Higher risk of depression, alcohol or other drug dependence
High risk of co-morbidity with other anxiety disorders
What neurotransmitter systems are targeted by anxiety drug treatments?
Serotonin
Noradrenaline
GABA
What are the disadvantages of benzodiazepines?
Withdrawal syndrome is frequently mistaken by patients as indicating that the anxiety for which the drug was originally started has returned
How do benzodiazepines assist with anxiety disorders?
Reduces somatic and psychological symptoms of anxiety in panic disorder, generalised anxiety disorder and for high potency benzodiazepines, social anxiety disorder
Why are barbiturates and benzodiazepines commonly mistaken for one another?
They are both in the same drug classification
They act similarly when it comes to how they affect the human body
What is the composition of barbituates?
Varies as it is an umbrella term for sedative-hypnotics that affect the CNS
What are the forms of barbituates?
Overwhelmingly were and are capsules or pills
What are the effects of barbiturates?
Sedative
Anxiety reduction
Hypnotic
Anti-conlulsant
Anesthetic
What are the disadvantages of barbiturates?
Highly addictive
Extremely dangerous if mismanaged
How is physiological and psychological dependence different for barbiturates and benzodiazepines?
Barbs:
High physiological and psychological dependence
Benzos:
Less physiological and psychological dependence
Can you use both barbiturates and benzodiazepines long term?
No
Barbs:
Long term use avoided due to toxicity
Benzo:
Long term use relatively safe
How does sleep differ for those taking barbiturates and benzodiazepines?
Barbs:
Sleep induced by it causes hangover effect after waking up
Benzo:
Sleep induced by it is just like natural sleep and is refreshing to wake up
How is the GABA CI channel affected by barbiturates and benzodiazepines?
Barbs:
Increase duration of GABA CI channel opening
Benzo:
Increase frequency of GABA CI channel opening
How does respiratory depression differ for barbiturates and benzodiazepines?
Barbs:
High respiratory depression
Benzo:
Manageable respiratory depression
How do beta blockers treat anxiety?
manages physical symptoms
Is there evidence of a dose-response relationship between anti-depressants and anxiety?
Little evidence
Many patients will respond to standard doses
Why should clinicians avoid rapid dose escalation for patients with anxiety?
Anxiety is generally slower to respond to treatment than depression
How long does it take for SSRIs and SNRIs to have an anxiolytic effect?
4-6 weeks
How long does buspirone take to have anxiolytic effects?
2 weeks
How does buspirone interact with the presynaptic and post synaptic receptors?
Buspirone is a full agnost at presynaptic 5HT1A receptors
Buspirone is a partial agonist at postsynaptic 5HT1A receptors
What are the serotonin pathways for SSRs and SNRIs?
Distribution of serotonin and raphe nuclei through context and into the cerebellum
What is the fear center model?
Threat > Sensory system > Fear circuit > fear responses (Defensive behaviour, physiological responses)
What is the two-system model?
Threat > sensory system cognitive circuit > fear ((Defensive survival circuit)) > Defensive responses
