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Anxiety (Panic Disorder (Tx (1st line (SSRIs, SNRIs), 2nd Line (TCAs,…
Anxiety
Panic Disorder
Recurrent panic attacks without a clear trigger
Sxs for one month
Waxes and wanes over time
Tx
1st line
SSRIs
SNRIs
2nd Line
TCAs
MAOIs
Pathopysiology
Fear
Amygdala centered circuit
Worry
Cortico-striatal-thalami-cortical circuit
Neurotransmitters
5-HT
Raphe nucleus
NE
Locus ceruleas
GABA
Inhibitatory
Generalized Anxiety Disorder
Worry most days for
at least 6 months
Worry is out of proportion
of events
3+ of the following...
Restlessness
Insomnia
Muscle tension
Fatigued
Can’t comcentrate
Irritability
Diagnosing
Step 1: Rule out substance induced causes
Step 2: Rule out medical conditions
Step 3: Characterize the Anxiety Disorder
Agoraphobia
Fear of...
(2 of the following)
Public transportation
Being in open spaces
Being in closed spaces
Being outside the home
Being in a crowd
Tx
Systemic desentizatiom
SSRIs/SNRIs/TCAs
Social Anxiety Disorder
Anxiety related to being judged by others
Blushing is a common sxs
Separation Anxiety Disorder
Great anxiety over separation
from an attachment figure
Children grow out of it
Specific Phobia
Related to specific thing or situation
Selective Mutism
Kids stop talking in social settings