Pharmacology and Anxiety Disorders

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Vocabulary flashcards summarizing major drug classes, specific agents, mechanisms, side effects, and treatment principles for anxiety disorders.

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21 Terms

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Benzodiazepines

Sedative-hypnotic anxiolytics that enhance GABA activity; useful short-term only due to tolerance, dependence, withdrawal risk, and respiratory depression when combined with other sedatives.

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Buspirone

Non-addictive anxiolytic and serotonin partial agonist for long-term use; minimal sedation, no abuse potential, but requires 2-4 weeks for full effect.

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Selective Serotonin Reuptake Inhibitors (SSRIs)

First-line drugs for all anxiety disorders; block serotonin reuptake, may initially increase anxiety; adverse effects include sexual dysfunction, insomnia, GI upset, bleeding risk, and suicidal ideation.

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Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)

Dual reuptake blockers (e.g., venlafaxine, duloxetine); venlafaxine is approved for panic disorder, GAD, and social anxiety disorder.

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Tricyclic Antidepressants (TCAs)

Second/third-line agents (e.g., amitriptyline, clomipramine); effective but cause anticholinergic, sedative, cardiac adverse effects and are lethal in overdose.

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Monoamine Oxidase Inhibitors (MAOIs)

Older antidepressants (e.g., phenelzine) sometimes used in social anxiety disorder; require tyramine-restricted diet to avoid hypertensive crisis.

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Beta Blockers

Propranolol, atenolol; blunt peripheral anxiety symptoms (e.g., tremor, tachycardia); can cause bradycardia, hypotension, fatigue, rare Stevens-Johnson syndrome.

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Alpha-2 Adrenergic Agonists

Clonidine, guanfacine; reduce sympathetic outflow to lessen anxiety; side effects include hypotension, dizziness, somnolence, AV block.

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Benzodiazepine Withdrawal

Taper-required syndrome featuring headache, tremor, anxiety, sweating, perceptual disturbances, and potentially life-threatening seizures.

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Serotonin Syndrome

Potentially fatal excess serotonergic activity causing hyperthermia, autonomic instability, neuromuscular hyperactivity, and altered mental status; treat by stopping offending drug, cyproheptadine, cooling, and supportive care.

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GABA (γ-aminobutyric acid)

Primary inhibitory neurotransmitter in the CNS; activity is potentiated by benzodiazepines to produce anxiolysis and sedation.

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Panic Disorder Treatment

Combines cognitive-behavioral therapy with medications such as SSRIs (fluoxetine, sertraline, escitalopram), short-term benzodiazepines, TCAs, or MAOIs.

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Post-Traumatic Stress Disorder (PTSD) Treatment

Typically involves trauma-focused therapy plus pharmacologic options like SSRIs or SNRIs; benzodiazepines generally avoided for long-term use.

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Kava Kava

Herbal product once thought anxiolytic but now linked to worsening psychiatric symptoms and potential hepatotoxicity.

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Valerian

Herbal remedy used for anxiety and insomnia; usually safe short-term but may cause headaches, excitability, and paradoxical insomnia.

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Alprazolam (Xanax)

Short-acting benzodiazepine for acute anxiety and panic attacks; high abuse and withdrawal potential.

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Clonazepam (Klonopin)

Long-acting benzodiazepine useful for panic disorder and seizure prophylaxis; carries same risks as others in its class.

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Diazepam (Valium)

Long-acting benzodiazepine with muscle-relaxant properties; risk for accumulation and sedation in older adults.

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Propranolol (Inderal)

Non-selective beta blocker used off-label to control performance anxiety by reducing somatic symptoms such as tachycardia.

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Cyproheptadine

Histamine-1 antagonist with serotonin-blocking properties used to reverse serotonin syndrome.

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Hydroxyzine (Vistaril)

Sedating antihistamine sometimes used PRN for anxiety; lacks dependence potential but causes anticholinergic and antihistamine side effects.