Generalized anxiety disorder: Treatment

SSRIs

for GAD include selective (SSRIs), which are antidepressants that influence brain chemistry to block the reabsorption of serotonin in the brain. SSRIs are mainly indicated for , but are also effective in treating disorders. Common side effects include nausea, sexual dysfunction, headache, diarrhea, among others. Common SSRIs prescribed for GAD include:

Other Drugs

Venlafaxine (Effexor) is a serotonin-norepinephrine reuptake inhibitor (). SNRIs, a class of drugs related to the SSRIs, alter the chemistries of both norepinephrine and serotonin in the brain. Imipramine (Tofranil) is a (TCA). TCAs are thought to act on serotonin, norepinephrine, and dopamine in the brain. Buspirone is a agonist belonging to the azaspirodecanedione class of compounds.

Benzodiazepines

Benzodiazepines (or “”) are fast-acting sedatives that are also used to treat GAD and other disorders. These are often given in the short-term due to their nature to become habit-forming. Side effects include drowsiness, reduced motor coordination and problems with equilibrioception. Common benzodiazepines used to treat GAD include:

Herbal

Kava, a relaxant made from a root only of a relative of the black pepper plant, is effective at controlling - particularly when used as a short term fast acting drug in combination with CBT (see below). The recommended use is for a support person such as the GAD sufferer’s partner or housemate to encourage a dose when strikes as the patient is often unwilling/unable to dose themselves. Kava is absorbed through most mucous membranes and takes effect in roughly the same time as alcohol. It is a symptomatic relief for and does not address the fundamental problem, but it does give the patient a reliable mental crutch to work through the core problems. It appears that the required dosage actually decreases with regular use, perhaps as a form of conditioning. Two major advantages of Kava supported therapy are the rapid response of the active ingredients (removing the need for titration) and the lack of withdrawal symptoms. There are no specific contraindications with other chemical treatments, but caution must be observed when the patient is already taking psychoactive drugs. Due to reports of serious liver damage related to the use of kava, many countries, particularly across Europe, have banned the sale of it. The risks and benefits of using kava, as with any drug, must be reviewed and proper caution must be exercised.

Cognitive behavioral therapy

A psychological method of treatment for GAD is cognitive behavioral therapy (CBT), which involves a therapist working with the patient to understand how thoughts and feelings influence behavior. The goal of the therapy is to change negative thought patterns that lead to the patient’s , replacing them with positive, more realistic ones. Elements of the therapy include exposure strategies to allow the patient to gradually confront their anxieties and feel more comfortable in -provoking situations, as well as to practice the skills they have learned. CBT can be used alone or in conjunction with medication.

CBT usually helps one third of the patients substantially, whilst another third does not respond at all to treatment.

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April 24, 2008 | Filed Under Mental Disorders 

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