anti-anxiety medications Valium Librium Xanax Klonopin Also used for sleeping pills & anti-seizure meds benzodiazepines
Jan 17, 2016
anti-anxiety medications
ValiumLibriumXanaxKlonopin
Also used for sleeping pills &
anti-seizure meds
benzodiazepines
anti-anxiety medications
“SSRIs”
ProzacPaxilZoloftCelexa
selective serotonin reuptake inhibitors
antidepressants
biological contributions
• polygenic trait of neuroticism**
• neurochemicals (GABA, NE, 5HT, CRH)
**comorbidity
generalized anxiety disorder
• 6 mo+ of uncontrollable worry to many issues
• 3+ of:
restlessness, fatigue, poor concentration,
irritable, muscle tension, sleep probs
• distress or impairment
CRITERIA
generalized anxiety disorder
• prevalence 3%
• 2:1 sex ratio
• onset 17-31 yrs (but most “always been this way”)
• prognosis: chronic
panic attack
inappropriate fear response
CRITERIA
4+ of:
heart palpitations, sweating, shaking, short of breath, choking, chest pain, nausea, dizzy, derealization/depersonalizaiton, fear of losing control, fear of dying, chills/heat, numbness/tingling
panic attack
cued – conditioned to external cues
uncued – conditioned to interoceptive cues
situationally predisposed
panic disorder
CRITERIA
• recurrent panic attacks
• 1+ for 1 mo+:
- concern about future attacks or consequences
- sig behavioral change (avoidance of external or internal cues)
panic disorder
• prevalence 3%• 2:1 sex ratio• relatives 8x more likely concordant
COGNITIVE-BEHAVIORAL THERAPY• cued: systematic desensitization• uncued: induce interoceptive sensations + cognitive restructuring of perceived control
agoraphobia
CRITERIA
anxiety about situations where:
- hard to access help
- escape difficult/embarrassing
specific phobia
CRITERIA
• 6+ mo persistent, excessive, irrational fear of an object of situation
• anxiety/fear on exposure
• avoided or endured w/ intense anxiety
• insight that phobia is irrational
specific phobia
• 9% prevalence
• 4:1 sex ratio
• prognosis: chronic
ETIOLOGY
-direct or vicarious trauma experience
-conditioning from panic attack
- information transmission
TREATMENT
systematic desensitization
social phobia
CRITERIA
• fear of social/performance situations
• anxiety/fear upon exposure
• insight that fear is irrational
• avoidance behavior impairs functioning
social phobia
• 7% prevalence
• 1: 1.4 sex ratio
CAUSE
prepared learning or, neuroticism/inhibition, conditioned direct exp
TREATMENT
exposure & cognitive therapy
OCD
CRITERIA
• recurrent & persistent thoughts/images
• associated behaviors compelled to perform
• insight to irrational “
• distress, consumes 1+ hr/day, or impairs functioning
ocd
obsessionsrepetitive, unwelcome thoughts
compulsionsrepetitive, almost irresistible action
• germs
• something bad will happen
• symmetry
• religion
• #s
• washing
• counting
• checking
• touching
• rituals
OCD
• 1% prevalence
• sex ratio?
• onset: childhood-30’s
• prognosis: chronic
TREATMENTS
• SSRIs, exposure + response prevention
ocdorbital frontal PFCbasal gangliacingulate
abnormal activation decreases after psychotherapy or anxiolytics