Download Pharmacological Treatments for Generalized Anxiety Disorder and more Papers Nursing in PDF only on Docsity! 1 Having generalized anxiety disorder (GAD) can be very difficult. This condition causes the patients to excessively worry about things out of their control or are challenging to control (Carl et al., 2019). This condition is often treated with pharmacologic agents such as serotonergic reuptake inhibitors (SRI), benzodiazepine, non-benzodiazepine, non-barbiturates, and non- pharmacological approaches such as therapy and cognitive-behavioral therapy (CBT), biofeedback, and relaxation training (Garakani et al., 2021) It is essential to have a long-term treatment and an as-needed treatment option available to treat GAD effectively. The first medication that would be useful for a patient with GAD would be Buspirone 7.5mg twice daily by mouth. This medication would be the long-term treatment as it has a low potential for abuse. The anxiolytic effects slowly develop and take several weeks to reach their peak effects. This medication can be titrated to an effective dose for each patient, and the usual range for this medication is thirty to sixty milligrams per day, split between two doses (Rosenthal & Burchum, 2021) Buspirone can be taken for up to a year, so it is an excellent option for initial treatment. This medication works by binding to serotonin receptors, reducing the number available for dopamine. Buspirone also works in combination with benzodiazepines as they bind to alternate receptors. Patients taking Buspirone will need to be monitored for dizziness, headache, sedation, nausea, and lightheadedness, as these are the most common side effects. After the patient is stabilized and their symptoms are controlled, they can then be transitioned to another medication such as Effexor XR 37.5mg daily that can be used long term and be titrated up to 225mg daily to effectively manage their anxiety symptoms (Carl et al., 2019) Effexor is a serotonergic-norepinephrine reuptake inhibitor (SNRI). It can be used to treat both anxiety and depression. When ordering SNRIs for patients, the provider needs to be sure to 2 provide education on the importance of tapering off the medication as abruptly stopping the medication can lead to withdrawal symptoms like insomnia, hyperarousal, flu-like symptoms, imbalance, and sensory disturbances (Rosenthal & Burchum, 2021). Second, there would need to be as-needed medication ordered, such as a benzodiazepine. This would be utilized to manage anxiety symptoms by enhancing the response to GABA inhibitor neurotransmitters (Garakani et al., 2021). These medications have an immediate effect and are used to reduce acute anxiety symptoms (Weber et al., 2021). Alprazolam 0.25mg TID as needed would be an appropriate starting dose to manage symptoms. Patients on this medication need to be monitored closely because of the abuse potential associated with benzodiazepines. The patients also need to be educated on potential side effects, including sedation and psychomotor slowing. Suddenly stopping Alprazolam can lead to withdrawal symptoms when taken frequently to manage acute symptoms. These withdrawal symptoms include panic, delirium, and paranoia and need to be monitored by the providers involved in the patient's care (Rosenthal & Burchum, 2021). References Carl, E., Witcraft, S. M., Kauffman, B. Y., Gillespie, E. M., Becker, E. S., Cuijpers, P., Van Ameringen, M., Smits, J. J., & Powers, M. B. (2019). Psychological and pharmacological treatments for generalized anxiety disorder (GAD): A meta-analysis of randomized controlled trials. Cognitive Behaviour Therapy, 49(1), 1–21. https://doi.org/10.1080/16506073.2018.1560358 Garakani, A., Freire, R. C., & Murrough, J. W. (2021). Editorial: Pharmacotherapy of anxiety disorders: Promises and pitfalls. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.662963