Comparing and Contrasting Pharmacologic Options for the Treatment of Generalized Anxiety Disorder Paper
Comparing and Contrasting Pharmacologic Options for the Treatment of Generalized Anxiety Disorder Paper
Comparing and Contrasting Pharmacologic Options for the Treatment of Generalized Anxiety Disorder (GAD)
Anxiety disorders are the most common mental condition among both children and adults with an increased risk of comorbid mood, significantly contributing to the world’s burden of disease. Epidemiological studies reveal that GAD affects approximately 5% of the entire population regardless of latitude, compromising their quality of life (Hurtado et al., 2020). For this reason, different types of anxiety medications are available for the management of the various types of anxiety disorders outlined in the DSM-V. This discussion illustrates a comparison of the pharmacokinetics and pharmacodynamics relating to the different pharmacological options for the management of GAD.
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Current clinical guidelines recommend the use of different classes of drugs for the management of anxiety disorders such as serotonin and noradrenaline reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOI), benzodiazepines and some antipsychotic and anticonvulsant in addition to miscellaneous agents, like 5-HT1A partial agonist, buspirone (Bandelow, 2020). SSRIs (citalopram, paroxetine, sertraline) and SNRIs (levomilnacipran, duloxetine, desvenlafaxine) have been approved by the FDA as first-line for the management of anxiety disorders in adults. These drugs are recommended as the first-line mainly due to the great association of anxiety disorders with depression, in addition to the fact that they lack the potential for abuse and dependence.
TCAs (amitriptyline, dosulepin, clomipramine) and MAOI (phenelzine, isocarboxazid) are considered second-line for the management of anxiety disorder. However, unlike SSRIs and SNRIs, the use of TCAs and MAOIs are somehow limited in clinical practice due to less favorable safety profiles and side effects such as weight gain, and increased toxicity (Schanzer et al., 2019). The third line includes drugs such as benzodiazepines, which are potent with rapid anxiolytic effects. However, they are considered controversial agents as a result of their inability to manage co-morbid depression and the associated risks of sedation, dependency, and memory problems.
Generally, several factors must be considered such as patient presenting symptoms, age, race, comorbidities, and overall health status among others, when deciding on what medication to prescribe for anxiety disorders. Consequently, evaluating the pharmacodynamics and pharmacokinetics of the available anxiolytics is crucial to promote the use of only safe and effective drugs for desirable treatment outcomes.
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References
Bandelow, B. (2020). Current and novel psychopharmacological drugs for anxiety disorders. Anxiety Disorders, 347-365. https://doi.org/10.1007/978-981-32-9705-0_19
Hurtado, M. M., Villena, A., Vega, A., Amor, G., Gómez, C., & Morales‐Asencio, J. M. (2020). ‘I have anxiety, but I have values and preferences’ Experiences of users with generalized anxiety disorder: A qualitative study. International journal of mental health nursing, 29(3), 521-530. https://doi.org/10.1111/inm.12690
Schanzer, B., Rivas-Grajales, A. M., Khan, A., & Mathew, S. J. (2019). Novel investigational therapeutics for generalized anxiety disorder (GAD). Expert opinion on investigational drugs, 28(11), 1003-1012. https://doi.org/10.1080/13543784.2019.1680638
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.
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