Chapter 38: Management of Anxiety Disorders

Question 1

Compare the effects of buspirone, benzodiazepines, and antidepressants for generalized anxiety disorder (GAD).

Answer 1

Buspirone: Slow onset, no abuse potential, no CNS depression, interacts with erythromycin, ketoconazole, and grapefruit juice.

Benzodiazepines: Rapid relief, risk of abuse/dependence, intensify CNS depressants.

Antidepressants (e.g., Venlafaxine): First-line for GAD, take weeks to work, side effects include nausea, headache, insomnia, and hypertension.

Question 2

Describe generalized anxiety disorder (GAD) and treatment

Answer 2

GAD: Chronic excessive worry (≥6 months).
* Treatment: CBT, SSRIs, SNRIs, benzodiazepines, buspirone.

Question 3

Describe panic disorder and treatment

Answer 3

Panic Disorder: Sudden panic attacks with physical/cognitive symptoms.
Treatment:
* 1st line - SSRIs (venlafaxine [Effexor XR])
* 2nd line - TCAs or benzodiazepines (short-term)
* 3rd line - MAOIs

Question 4

Describe obsessive-compulsive disorder (OCD) and treatment

Answer 4

OCD: Obsessions (persistent thoughts) & compulsions (ritualistic behaviors).
* Treatment: 1st line - SSRIs (citalopram, escitalopram, fluoxetine); 2nd line - TCA (Clomipramine [Anafranil]).

Question 5

Describe social anxiety disorder and treatment

Answer 5

Social Anxiety Disorder: Intense fear of social scrutiny.
* Treatment: SSRIs (Paroxetine, Sertraline), beta blockers (Propranolol), benzodiazepines (clonazepam [Klonopin] or alprazolam [Xanax]).

Question 6

Describe post-traumatic stress disorder (PTSD) & treatment

Answer 6

PTSD: Trauma-related re-experiencing, avoidance, hyperarousal.
* Treatment: Psychotherapy, SSRIs (Fluoxetine, Paroxetine, Sertraline), SNRI (Venlafaxine).