Diagnosis:
- Generalized anxiety disorder (GAD)
- Panic disorder (PD)
- Social anxiety disorder (SAD)
Symptoms:
- Anxiety: unpleasant feeling of dread, apprehension or tension resulting from an unexpected threat to one's feeling of self esteem or well being
Frequency:
- most common psych disorder encountered
- high relapse/recurrence
Induced by meds:
Use:
5 - Serotonin receptor agonist:
- Generalized anxiety disorder (GAD)
- Panic disorder (PD)
- Social anxiety disorder (SAD)
Symptoms:
- Anxiety: unpleasant feeling of dread, apprehension or tension resulting from an unexpected threat to one's feeling of self esteem or well being
Frequency:
- most common psych disorder encountered
- high relapse/recurrence
Induced by meds:
- Anticonvulsants
- antidepressants
- decongestants
- corticosteroids
Induced by dz:
- angina
- migraine
- hyperthyroid
- asthma
- substance abuse
Drug therapy:
1 - SSRIs
2 - SNRIs
3 - BZD
4 - Anticonvulsants
5 - Serotonin receptor agonist
6 - Atypical antipsychotics
7 - Tricyclic antidepressants (TCAs)
8 - MAOIs
Drug therapy:
1 - SSRIs (1st choice)
- Fluoxetine-----Fluo-XETINE
- Paroxetine ----Paro-XETINE
- Sertraline
- fluvoxamine
- citalopram-----CITA-LOPRAM
- escitalopram---es-CITA-LOPRAM
Onset: 2-4 wks
2 - SNRIs (1st choice)
- duloxetine
- venlafaxine
Onset: 2-4 wks
3 - BZD:
- alprazolam
- clonazepam
- diazepam
- lorazepam
- oxazepam
- chlordiazepoxide
- clorazepate
rapid acute tx for acute anxiety 1st choice
Antidote: flumazenil
4 - Anticonvulsants:
- Pregabalin------GAD only
- Gabapentin------SAD ----(mnemonics:GABA-PENsion-in-a-TIN is usually old & SAD due to social isolation (social anxiety disorer) fearing being judged for their old age
Use:
- scheduled V
- withdrawal if abrupt stopping
 |
| Prego-GABA ==> eats too much => GAG = GAD (Generalized Anxiety Disorder) |
 |
| Ong do gia - Social Isolation leading to SOCIAL anxiety disorder (SAD) |
- buspirone
Onset: 14 days
6 - Atypical antipsychotics:
- risperidone
- olanzapine
- quetiapine
2nd line
onset faster than SSRI or SNRI
7 - Tricyclic antidepressants (TCAs)
- clomipramine
- imipramine
3rd line for panic disorder (3rd line = tri = tricyclic)
8 - MAOIs
- phenelzine
for refractory
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