Current and future treatments for Anxiety

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Four types of drug for anxiety
Benzodiazapines, Beta Blockers, Buspirone, Antidepressants
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Two types of antidepressant used for anxiety
SSRIs, SNRIs, TCAs, MOAIs
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What disoders are SNRIs and SSRIs good for
Panic disorder, OCD, PTSD, social phobia. GAD.
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Good things about SNRIs and SSRIS
they have few side effects and have low potential for abuse.
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Side effects in anxious patients using antidepressants
nausea, diarrhea, headache, anxiety more prone to jitteryness.
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What disorders are TCAs good for?
panic disorder and generalised anxiety disorder, and OCD.
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Problems with TCAs
Much larger side effect profile and more dangerous in overdose.
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What anxiety disorders are MAOIs effective for>
PD and SAD and social phobia. But worst side effect profile of all, and greatest safety burden.
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How do BDZs work
Bind to a BZ site on the a-subunit of the GABAa receptor. Facilitate GABA inhibitory effects.
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How are BDZs prescribed
Second line treatment, Previously first line. Short periods of time, except in panic disorder.
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When can BZs be used
Short term anxiety (aeroplane trip) or in the weeks before antidepressants have an effect
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Why have BZs been linked to poor response in CBT?
Taking pills on an as needed basis encourages avoidal and postively reinforces avoidance behaviour
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Side effects
Dependance, short term cog and psychomotor impairment, rebound anxiety
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When can Beta Blockers be used?
Single dose agents for performance-related, predictable anxiety. Can reduce physical symptoms.
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Why are antidepressants now thought to be first line treatment?
GAD often has a depression componant
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What is buspirone?
A new antianxiety medication used to treat GAD. a 5ht1a receptor partial agonist.
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Side effects of buspirone, AN ASPIRONE
dizziness, headaches and nausea. 2 weeks to achieve an effect.
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NEW TREATMENTS FOR ANXIETY x
anticonvulsants, which are superior to placebo in GAD. Neuropeptides. CRF
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Neuropeptide targets in clinical trials
Substance P - NK1 receptor antagonists reduce anx and depression, and have less side effects than traditional. But then failed clinical trials.
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Rationale behind CRF
crf mediates activity in the HPA axis which mediates behavioural, immune and autonomic aspects of teh stress response. Hypersecretion of CRF is critical to the developlent of anx disorders.
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Another neuropeptide under consideration
NPY and vassopressin 1 b receptors. NPY might be an endogenous alarm system.
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Two types of antidepressant used for anxiety

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SSRIs, SNRIs, TCAs, MOAIs

Card 3

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What disoders are SNRIs and SSRIs good for

Back

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Card 4

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Good things about SNRIs and SSRIS

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Card 5

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Side effects in anxious patients using antidepressants

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