Anxiety

Anxiety

  • ~15% of people are affected (only 1/3 that suffer seek treatment–not curative in most cases but can decrease symptoms and increase quality of life)
  • Life events can be the cause (anxiety is usually self-limiting if the event was acute)
  • Commonly occurs concomitantly with other psych disorders especially depression
  • Generalize anxiety disorder (GAD)
    • Most common anxiety disorder which is a chronic condition that has a gradual onset
    • Diagnosis is based on DSM criteria
    • Associated with genetic factors & the GABA-benzo receptor complex
      • Benzos bind to GABA receptors which open the Cl ionophore channel  eventually stabilizing the membrane & thus inhibiting neuron firing(GABA inhibits other NTs such as serotonin, NE, & DA).
    • Causes of anxiety might include an endogenous agonist binding to this GABA receptor
    • Noradrenergic systems:  the locus ceruleus area of the brain is the main source of NE & its stimulation causes both arousal & symptoms of anxiety.
    • Serotonergic systems:  an excess of serotonin can cause anxiety
    • Treatment:
      • Nonpharm:  psychotherapy, decrease stressors, relaxation training, biofeedback training, combo w/ drug therapy
      • Benzos:  most common, low toxicity/abuse/ddi.  Benzos have 4 effects–anxiolytic, anticonvulsant, muscle relaxing, sedative-hypnotic
      • Buspirone:  partial agonist of serontoning Type 1A receptor, doesn’t bind to benzo receptors or interact w/ GABA.  Comparable efficacy to benzos.  No abuse potential/dependence/sedation/cognitive changes/muscle relaxation but it does take a while to work
      • Antidepressants (ex. TCAs, SSRIs, MAIOs):  may be better than benzos in the treatment of anxiety (more of a prevention treatment)
      • Beta-blockers (ex. Propranolol)

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