Anxiety Flashcards
Diagnostic Criteria for General Anxiety Disorder (GAD)
persistent symptoms for at least 6 months
accompanied by at least 3 psychologic or physiologic symptoms
- excessive anxiety
- worries that are difficult to control
- feeling on edge
- poor concentration
- restlessness
- fatigue
- muscle tension
- sleep disturbances
- irritability
- social / occupational impairment
- poor coping skills
Diagnostic Criteria for Panic Disorder
Series of unexpected, spontaneous attacks of intense fear
Attack followed by at least 1 month of fear of recurrence
>/= 4 symptoms during attack:
- Fear of losing control, going crazy, dying
- depersonalization
- de-realization
- abdominal distress/ nausea
- chest pain/discomfort
- chills/hot flashes
- palpitations/tachycardia
- SOB
- trembling
- sweating
Diagnostic Criteria for Social Anxiety Disorder (SAD)
duration must be at least 6 months
fears:
- judgement
- embarrassment
- humiliation
Diagnostic Criteria for Post Traumatic Stress Disorder (PTSD)
Exposure to traumatic event is required
- threatened death or serious injury
- possible harm to self or others
Patients must have at least:
- 1 intrusion symptom
- 1 avoidance symptom
- 2 negative alterations in cognition and mood
- 2 symptoms of increased arousal
Symptoms must be present > 1 month
Intrusion Symptoms (PTSD)
- recurrent, intrusive, distressing memories of the trauma
- recurrent, disturbing dreams of the event
- dissociative flashbacks
- physiologic reaction or psychological distress from reminders of trauma
Avoidance Symptoms (PTSD)
- avoiding conversations, thoughts, or feelings about the event
- avoiding people, places, or activities that are reminders of the event
Negative alterations in cognition and mood (PTSD)
- inability to recall an important aspect of the trauma
- anhedonia (lack of pleasure)
- estrangement from others
- restricted affect
- negative beliefs about oneself
- distorted beliefs about oneself
- distorted beliefs causing one to blame others or themselves for the trauma
- negative mood state
Increased Arousal Symptoms (PTSD)
- decreased concentration
- easily startled
- hypervigilance
- sleep disorders
- agitation, irritability, outbursts
- self destructive behavior
Diagnostic Criteria for Obsessive Compulsive Disorder (OCD)
obsession- persistent recurrent idea-thought-impulse that is intrusive and inappropriate and produces marked anxiety
compulsion- repetitive behavior or mental act performed in response to an obsession.
Common Antidepressant Side Effects
- HA
- GI upset
- insomnia
- sexual dysfunction
- weight gain
- increased anxiety (early)
- drowsiness
- tremor
- increased bleed risk
- Serotonin syndrome
- withdrawal/ discontinuation syndrome
SSRI’s approved for GAD
Escitalopram (Lexapro)
Paroxetine (Paxil)
SNRI’s approved for GAD
Duloxetine
Venlafaxine
GAD nonbenzodiazepine anti-anxiety agents
Vortioxetine (Trintellix)
Pregabalin (Lyrica)
Quetiapine XR (Seroquel XR)
1st line treatment for GAD
SSRI:
- escitalopram
- paroxetine
- sertraline
SNRI
- duloxetine
- venlafaxine XR
2nd line treatment GAD
Buspirone
Imipramine
Antihistamines
- Hydroxyzine
Antipsychotics
- Quetiapine XR
Benzodiazepines (If no SUD)
