Anxiety Disorders

Question 1

What are some non drug treatments for anxiety?

Answer 1

• Lifestyle changes (increased physical activity, helping others, yoga, meditation…)
• Cognitive Behavioral Therapy

Question 2

What are some of the natural products that are used for anxiety?

Answer 2

• St. Johns Wart (Depression & Anxiety)
• Valerin (Sleep & Anxiety)
• Passionflower
• Kava (NOT recommended due to liver damages)

Question 3

What are the 1st line drugs that are used for Anxiety?

Answer 3

• Escitalopram [Lexapro] SSRI
• Fluoxetine [Prozac] SSRI
• Paroxetine [Paxil] SSRI
• Sertraline [Zoloft] SSRI
• Duloxetine [Cymbalta] SNRI
• Venlafaxine [Effexor] SNRI

Question 4

What are the 2nd line drugs that are used for anxiety?

Answer 4

• Buspirone
• TCAs; Amitriptyline, Nortriptyline
• Hydroxyzine
• Pregabalin (Lyrica), Gabapentin (Neurontin)

Question 5

What is the MOA for buspirone used for anxiety?

Answer 5

• Not sure; has affinity for 5-HT1A & 5-HT2 Receptors

Question 6

What are some contraindictions for Buspirone used for Anxiety?

Answer 6

• DO NOT used with MAOi

Question 7

What are some warnings for buspirone used in anxiety?

Answer 7

• Risk of serontonin syndrome

Question 8

What are some side effects for Buspirone used for Anxiety?

Answer 8

• Headache, Dizziness, Drowsiness, Lightheadedness

Question 9

What is the MOA for the benzodiazepines used for anxiety?

Answer 9

• Enhance GABA (inhibitory neurotransmitter) = CNS Depression

Question 10

What are some important things to keep in mind about the Benzodiazepines used for anxiety?>

Answer 10

• Fast Relief of anxiety
• Short term use only (acute symptoms)
• Risk of dependence (must used for 1 - 2 weeks then taper)
• BEERS CRITERIA (due to the CNS depression)

Question 11

What are some of the Benzodiazepines that are used for anxiety?

Answer 11

• Alprazolam (Xanax)
• Clonazepam (Klonopin)
• Diazepam (Valium)
• Lorazepam (Ativan)

Question 12

What are some of the boxed warnings for the benzodiazepines used for anxiety>

Answer 12

• Used with opioids = increases sedation, respiratory depression, or death
• Risk of abuse, ,missue, or addiction
• Phyiscal dependence (MUST TAPER SLOWLY)

Question 13

What are some of the contraindications for benzodiazepines used for Anxiety?

Answer 13

• Severe liver disease

Question 14

What are some warnings for Benzodiazepines used for anxiety?

Answer 14

• CNS Depression
• Anterograde amnesia
• ABUSE
• Risk in those over 65 years old (BEERS)
• Pregnancy

Question 15

What are some side effects for the benzodiazepines used for anxiety

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Answer 15

• Somnolence, dizzinessm ataxia

Question 16

What are some addtional notes for the Benzodiazepines used for Anxiety?

Answer 16

• C-IV
• Commonly used for alcohol withdrawal syndromes (loraze, diaze, chlorodiaze)