anxiety disorders

anxiety disorder symptoms are

chronic and severe

drugs that cause anxiety

albuterol (if used too frequently or incorrectly

antiphychotics (aripiprazole, haloperdiol)

buproprion

caffeine in high doses

decpngestamts

cocaine, lsd, meth

levothyroxone (if overdose occurs)

steroids

stimulants (amph, methylphenidate)

theophylline

natural products for anxiety

st johns wort- photosensitivity and serotonergic

valerian- anxiety and sleep

passionflower

kava- can cause severe liver damage and not recommended

first line treatment. how long does it take to see effectiveness

SSRIs, SNRIs

escitalopram, fluoxetine, paroxetine, sertraline, duloxetine, venlafaxine

takes 4 weeks

second line treatment

buspirone, tcas, amitrip and nortrip, gabapentin, pregabalin

how long does it take to see buspirone effect

does not provide immediate relief; 2-4 weeks

hydroxyzine not used

shouldnot be used longterm; sedating antihistamine with anticholinergic activity

pregabalina nd gabapentin typically used for

anxiety and neuropathic pain

buspirone contraindication

MAO inhibitor use

buspirone warnings

risk of serotonin syndrome

buspirone notes

no potential for abuse, tolerance, or physiological dependence

buspirone has an affinity for which receptors

5-HT1A and 2

benzodiazipines enhance

GABA an inhibitory neurotransmitter

bzds are useful for

short term treatment of acute anxiety

bzds hsould only be used for long due to ?

only be used for 1-2 weeks and then discontinued due to risk of dependence

should be tapered off slowly to avoid withdrawal

if using bzds for anxiety consider

longer half life and less risk for abuse

CLAD- clonazepam, lorazepam, alprazolam, diazepam

sleep (bzd)

consider temazepam if used

seizures (bzd)

injectable bzd or diazepam (rectal gel)

bzd containdications

severe liver disease

bzd warnings and side effects

cns depression, anterogade amnesia, crosses placenta in pregnancy, somnolence, dizziness, ataxia

bzds alcohol withdrawla symptoms

lorazepam, diazepam, chlordiazepoxide

alprazolam is contraindicated with

strong cyp3a4 inhibitors