Comparing and Contrasting Pharmacologic Options for the Treatment of Generalized Anxiety Disorder Essay
Comparing and Contrasting Pharmacologic Options for the Treatment of Generalized Anxiety Disorder Essay
There are various pharmacotherapy approaches for the treatment of generalized anxiety disorder. (GAD). The main classes of FDA-approved drugs for the treatment of GAD are selective serotonin, selective norepinephrine reuptake inhibitors (SSRIs and SNRIs), azapirones, and benzodiazepines. An example of an SSRI approved for the treatment of GAD is Sertraline. Sertraline acts by increasing serotonin activity while blocking its reuptake (Garakani et al., 2020). Sertraline shows efficacy and well-tolerability in both adults and children. Additionally, the medication is safe and well-tolerated in the older adult population. While it has low chances of advanced events, the occurrences are higher in the pediatric population compared to adults (Strawn et al., 2018).
Benzodiazepines class of drugs bind GABA to induce feelings of calmness. An example is diazepam. Benzodiazepines are effective for treating GAD with a faster response than SSRIs and SNRIs. Moreover, studies show they give better remission than SSRIs and SNRIs. However, they are not well-tolerated with the pediatric and older adult populations posing the risk of harm (Sartori & Singewald, 2019). Additionally, Benzodiazepines are not commonly prescribed because of the high risk of dependence, abuse, toxicity, and tolerance (Strawn et al., 2018). Due to this, the recommended pharmacotherapy using the medication is 3-6 months, yet this period is not enough for GAD treatment. Hence, people at high risk of abuse should not be given this class of medication.
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Azapirones is another class of drug for the treatment of GAD. The only FDA-approved drug from this class is buspirone, an anxiolytic and 5-HT1A receptor agonist (Strawn et al., 2018). The medication effectively treats GAD and is well-tolerated by both adults and the pediatric population. Similarly, the drug is well-tolerated in older adults with no requirement for dose adjustments (Sartori & Singewald, 2019). However, like SSRIs and SNRIs, Azapirones are safer but give lower efficacy than benzodiazepines. Finally, SNRIs like SSNIs act by causing changes in the brain that affect the functioning of neurotransmitters. An example approved for GAD is Effexor, which is well-tolerated and effective for treating GAD in adult and pediatric populations. However, it is associated with pain, weight loss, asthenia, and anorexia (Strawn et al., 2018).
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References
Garakani, A., Murrough, J., Freire, R., Thom, R., Larkin, K., Buono, F., & Iosifescu, D. (2020). Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options. Front Psychiatry, 11:595584. https://doi.10.3389/fpsyt.2020.595584. PMID: 33424664; PMCID: PM.
Sartori, S. B., & Singewald, N. (2019). Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders. Pharmacology & Therapeutics, 204, 107402. https://doi.org/10.1016/j.pharmthera.2019.107402.
Strawn, J., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert Opin Pharmacother, 19(10),1057-1070. https://doi.10.1080/14656566.2018.1491966.
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Discussion: Comparing and Contrasting Pharmacologic Options for the Treatment of Generalized Anxiety Disorder
Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.
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Generalized Anxiety Disorder is a psychological condition that affects 6.1 million Americans, or 3.1% of the US Population. Despite several treatment options, only 43.2% of those suffering from GAD receive treatment. This week you will review several different classes of medication used in the treatment of Generalized Anxiety Disorder. You will examine potential impacts of pharmacotherapeutics used in the treatment of GAD. Please focus your assignment on FDA approved indications when referring to different medication classes used in the treatment of GAD.
To Prepare
Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
Think about a personalized plan of care based on these influencing factors and patient history with GAD.
By Day 3 of Week 8
Post a discussion of pharmacokinetics and pharmacodynamics related to anxiolytic medications used to treat GAD. In your discussion, utilizing the discussion highlights, compare and contrast different treatment options that can be used.
REources:
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 26, “Antipsychotic Agents and Their Use in Schizophrenia†(pp. 203–213)
Chapter 27, “Antidepressants†(pp. 214–226)
Chapter 28, “Drugs for Bipolar Disorder†(pp. 228–233)
Chapter 29, “Sedative-Hypnotic Drugs†(pp. 234–242)
Chapter 30, “Management of Anxiety Disorders†(pp. 243–247)
Chapter 31, “Central Nervous System Stimulants and Attention-Deficit/Hyperactivity Disorder†(pp. 248–254)
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