Generalized anxiety disorder
Respond to at least to your colleagues on two different days 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.
No negative words
K Packer
Week 8 Main Post
Uncontrolled worrying is a chronic condition described as generalized anxiety disorder, it more than likely requires long-term treatment, and usually has another psychiatric disorder (GAD) (Rosenthal & Burchum, 2021). The National Institute of Mental Health (NIH) states that excessive anxiety and worrying about work, school, or several other incidents to the point of it interrupting activities of daily living (ADL) is significant for GAD (1). The NIH reports that 5.7% of adults in the U.S. have at some point in their life experienced GAD and of those diagnosed, 32.3% have had a serious impairment.
Pharmacokinetics
Rosenthal & Burcham (2021) states that Serotonergic Reuptake Inhibitors (SRIs), include selective serotonergic reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitor (SNRIs), should be the medications to start treatment for GAD. They are well tolerated and have minimum side effects compared to benzodiazepines. Response time for SSRIs and SNRIs is slow to work, begins in about a week with the peak benefits over several weeks which are not appropriate for as-needed use compared to benzodiazepines, for example, Ativan as reported by Rosenthal and Burcham.
Pharmacodynamics
Serotonergic uptake inhibitors exert their effect on the body by increasing the level of serotonin in the brain by interfering with the reabsorption by presynaptic neurons (Mandall, 2010). The inhibition by the presynaptic neurons in turn allows more serotonin to be available for mood-altering therapy. The increase in serotonin levels decreases the clinical signs of depression.
Pharmacogenetics
The highest rate was seen in females ages 30 – 44 years of age and adolescent females aged 17 – 18 as reported by NIH. Tomasi et al. (2019) report that there is enough information that warrants further studying, but all psychiatric disorders are deemed polygenic, and studies and participants for gene-related studies are few. Recent findings suggest among students in a university in Brazil identified as black demonstrated a greater risk for GAD compared to white and brown students (da Silva Júnior et al., 2021).
Personalized Care Plan
The patient’s plan will include the first-line treatment of paroxetine 20 mg daily for the management of anxiety and reschedule an office visit in 4 to 6 weeks to determine the effectiveness of the current therapy. If little or no improvement, then increases the Paxil to 40 mg daily and reschedule the patient for another visit. Will maintain therapy if the patient shows improvement, if not will add Venlafaxine (Effexor XR) for treatment of depression at 37.5 mg, oral daily. In addition to the medication, nonmedical therapy will include:
Encouraging the patient to get at least 8 hours of sleep daily
Eat a balanced diet
Maintain a regular routine
Get out of the house, even for a short walk
Regularly exercise
Stay away from consuming alcohol and illicit drugs
Talk with family & friends
Encourage participation in group activities (Medline Plus, n.d.).
