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Anxiety (medical causes of anxiety (medications (stimulants, tranquilizers…
Anxiety
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treatment
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non-pharmacologic: relaxation training, hypnosis, biofeedback, CBT, exposure and response tx - this is first line for chronic anxiety - gives you feeling of control
benzos
acute anxiety, esp in cardiac pts
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inverse agonist (beta-carbalenes) - less activity - put in to turn up the gain on nervous system - enhancing arousal - anxiety disorder probably have too much inverse agonist
BZD receptors
type 1: anxiolytic (limbic, locus coroeleus)
type 2: muscle relaxation, sedation, anticonvulstant
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long half life: less frequent, more accumulation, slower onset, longer, more attenuated
complex metabolism: diazepam, chlordiazepoxide, flurazepam
sedating, psychomotor impairment, discontinuation syndrome, interactions w/ other depressants (esp alchohol)
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alternatives to benzos
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gabapentin, pregabalin, divalproex - harder to tolerate and dose
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choices
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anxiety in substance abuse: antidepressant, anticonvulsant, buspirone
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chronic anxiety: antidepressant, CBT
anxiety in pulm pts: buspirone, antidepresant
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panic disorder: antidepressant, CBT
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social anxiety: antidepressant, exposure
Generalized Anxiety
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restlessness, easily fatigued, muscle tension, insomnia, irritability, trouble concentrating
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anxiety trait is familial, but GAD is not
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panic anxiety
no specific content; intense, unprovoked
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Panic Attack
overwhelming anxiety out of the blue, feel like you're about to die; lasts a few minutes
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