The Management Of Generalized Anxiety Disorder Discussion

The Management Of Generalized Anxiety Disorder Discussion

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Discussion Response

Thank you for your input on the discussion topic. As mentioned, the management of GAD differs depending on some factors, including age, gender, and genetics, among other things. GAD in older patients often is accompanied by depression which can result in physical and cognitive impairment, and thus, treatment must be well-planned. It is also important to consider that age affects the pharmacodynamics and pharmacokinetics of the drug. In elderly patients, changes in the body’s physiology, current medications, and existing comorbidities interfere with a drug’s pharmacokinetics and pharmacodynamics. Therefore, the provider must fully know the patient’s comorbidities and current drugs before administering medications. For example, SSRIs are not recommended in patients using statin drugs for cardiovascular diseases as the drugs may interact, resulting in the inhibition of cytochrome that may cause severe statin effects (Andrade, 2014). While the treatment of GAD is effective when using pharmacological treatments, several psychotherapies are also productive. According to Servant (2019)The Management Of Generalized Anxiety Disorder Discussion, cognitive behavioral therapy can be a first-choice psychotherapy in treating GAD. CBT primarily focuses on psychoeducation, exercise, and psychosocial support. The patient is encouraged to identify triggers for their anxiety and find practices such as deep breathing, relaxation, exercise, and cognitive restructuring to cope with the issues. The optimal outcomes are achieved when CBT is combined with other pharmacological treatment options.

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References

Andrade, C. (2014). Selective serotonin reuptake inhibitor drug interactions in patients receiving statins. The Journal of Clinical Psychiatry, 75(02). https://doi.org/10.4088/jcp.13f08941

Servant D. (2019). Traitement non médicamenteux des troubles anxieux [Non-pharmacological treatment for anxiety disorders]. La Revue du praticien, 69(9), 985–987. The Management Of Generalized Anxiety Disorder Discussion

Read a selection of your colleagues’ responses and respond  by suggesting additional factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients diagnosed with GAD. In addition, suggest different treatment options you would suggest to treat a patient with the topic of discussion. NEED 2 REFERENCES Colleagues Response is below.

 A common psychiatric disease called generalized anxiety disorder (GAD) is characterized by excessive, uncontrollable worrying that makes it difficult to go about daily tasks (Moorthi, 2023). GAD is frequently treated with anxiolytic drugs like benzodiazepines and selective serotonin reuptake inhibitors (SSRIs).
The study of a drug’s absorption, distribution, metabolism, and elimination by the body is known as pharmacokinetics. Pharmacodynamics is the study of how medications interact with particular molecular targets in the body to produce therapeutic effects.
Sedation and anxiolysis are produced when benzodiazepines, such as lorazepam and alprazolam, act on the gamma-aminobutyric acid (GABA) receptor to improve its inhibitory actions (Doyno & White, 2021)The Management Of Generalized Anxiety Disorder Discussion. Following oral administration, they are quickly absorbed and begin to act. Due to the possibility of dependence, withdrawal symptoms, and cognitive impairment, benzodiazepines are often not advised for long-term use.
By preventing serotonin’s reuptake, SSRIs like sertraline and escitalopram are hypothesized to raise its levels in the brain. Compared to benzodiazepines, they take longer to start working and may take several weeks to fully exert their therapeutic effects. In comparison to benzodiazepines, SSRIs are typically well tolerated and carry a decreased risk of dependence and withdrawal.
When creating an individualized plan of care for a patient with GAD, it’s crucial to take into account variables like genetics, age, gender, and comorbidities that could affect how well the patient responds to medication. For instance, individuals with liver or kidney disease may need dose adjustments due to reduced drug clearance, whereas elderly patients may need lower doses of medication due to changes in their metabolism (Bhaskar et al., 2022)The Management Of Generalized Anxiety Disorder Discussion.
In conclusion, while both benzodiazepines and SSRIs are successful therapies for GAD, their pharmacokinetic and pharmacodynamic characteristics are different. Clinicians should take into account the unique characteristics and preferences of each patient when selecting a treatment to create a tailored care plan.

References
Bhaskar, M., Telessy, I. G., & Buttar, H. S. (2022). The Importance of Drug Dose Adjustment in Elderly Patients with Special Considerations for Patients on Diverse Co-medications and Antidepressants. Biomedical Translational Research: Drug Design and Discovery, 231-272.
https://link.springer.com/chapter/10.1007/978-981-16-9232-1_15
Doyno, C. R., & White, C. M. (2021). Sedative‐Hypnotic Agents That Impact Gamma‐Aminobutyric Acid Receptors: Focus on Flunitrazepam, Gamma‐Hydroxybutyric Acid, Phenibut, and Selank. The Journal of Clinical Pharmacology, 61, S114-S128.
https://accp1.onlinelibrary.wiley.com/doi/abs/10.1002/jcph.1922?casa_token=M7_3KQ-llhMAAAAA:DOs8362mNzVB929LuieluWg0hz1BZ-P4tOjHXcQmvoTx_aOgw38L1e1O5Ek-_pCKzEUy6gccH4J4x2dE
Moorthi, K. (2023). Homoeopathy in the management of generalised anxiety disorder: A case report. Indian Journal of Research in Homoeopathy, 17(1), 5.
https://ijrh.researchcommons.org/journal/vol17/iss1/5/The Management Of Generalized Anxiety Disorder Discussion

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 Class Resources:

• 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) The Management Of Generalized Anxiety Disorder Discussion