Anxiety Disorder

Fear

emotional response

Anxiety

anticipation

GAD pharmacotherapy

SSRIs + anxiolytics

Benzos

Panic Disorder pharmacotherapy

SSRIs (block attacks in 70-80% patients)

What should panic disorder patients avoid

caffeine

Social Phobia pharmacotherapy

fluoxetine and sertraline

PTSD pharmacotherapy

Sertraline

Benzos

What brain araes are in the ‘worry loop’

Cortex

Thalamus

Striatum

What is GABA produced from

glutamate

What neurotransmitters are involved in Anxiety

GABA

NE

5-HT (serotonin)

benzos mechanism

PAM on GABA-A

Explain benzos on GABA and the mechanism

Benzos increase GABA firing (inhibitory) so it decreases fear and worry

GABA

Main inhibitory neurotransmitter

What area is overactive in fear

Amygdala

What arae is overactive in worry

cortico-striatum-thalamic loop

What is the main resason for anxiety disorders

Too much firing and activity in amygala and cortical pathways

Amygdala and PAG

fight or flight motor response

Amygdala and Hormones

Amygdala and hypothalamus/ pituitary glands

Amygdala and parabrachial nucleus

Respitory rate

Amygdala and locus coreleus

chronis disease form high NE

Amygdala and Hippocampus

Memories of fearful experiences

What is the basic theraputic action of benzos in the amygdala

Benzos on gaba cause increases inhibition and reduce activation of fear and worry circuits

benzos SE’s

cog impariments

sedation

dimentia symptoms

What is Busiprone

A 5HT1A agonist

Why is Busiprone and SSRI preferred to benzos

calming effect - SE’s

Busiprone mechanism

Increases serotonin in needed structured through 5HT1A receptor

What does NE do generally

Increase fear and worry

What is NE as a neurotransmitter

right or flight neurotransmitter

What does high NE in the fear circut do?

Increase NE in the amygdala which increases arousal and anxiety

NET

Neropinephrine Transporter

Nuerotrphic hypotesis of depression

Depression may be caused by reduced synthesis of proteins involved in neurogenesis and synaptic plasticity

In PTSD what drug has a caution for addiction

Benzos