NURS 6630 Comparing and Contrasting Pharmacologic Options for the Treatment of Generalized Anxiety Disorder
Comparing and Contrasting Pharmacologic Options for the Treatment of Generalized Anxiety Disorder
The occurrence of spontaneous remission in individuals with generalized anxiety disorder (GAD) is less than 33% (Slee et al., 2019). Furthermore, the symptoms of GAD exhibit fluctuations over the course of an individual’s lifetime. Psychopharmacologic therapy has the potential to alleviate the burden associated with GAD. The benzodiazepine class of medications, including a recently developed extended-release version of alprazolam, has been extensively studied and demonstrated to be effective in treating GAD (Sartori & Singewald, 2019). The drug exhibits a relatively low frequency of adverse reactions; however, they possess the potential to induce physical reliance, withdrawal symptoms, and sedative effects.
Antidepressants have also demonstrated efficacy in the treatment of GAD, although with a slower onset of action compared to benzodiazepines. Tricyclic antidepressants, like imipramine, have been found to significantly alleviate symptoms of anxiety (Slee et al., 2019). However, due to the range of side effects associated with these medications, they are not typically recommended as an initial treatment option. The efficacy of extended-release venlafaxine and selective serotonin reuptake inhibitors, such as paroxetine and sertraline, has also been observed in the treatment of GAD (Carl et al., 2019). Although the potential link between these medications and sexual dysfunction may be deemed unacceptable by certain individuals, it is worth noting that they may be a more suitable option compared to benzodiazepines due to their lack of propensity for inducing dependence with long-term usage.
Additionally, it has been observed that buspirone exhibits a substantial decrease in symptoms associated with GAD. There is a lower incidence of sexual dysfunction associated with this medication compared to SSRIs, as well as a lower level of sedation compared to benzodiazepines (DeMartini et al., 2019). The concurrent administration of antidepressant and benzodiazepine therapy, as well as the combination of medication treatment and psychotherapy, has been found to potentially enhance the therapeutic outcomes in patients who do not exhibit a favorable response to a single treatment modality. The optimal approach for addressing the recurring symptoms of this enduring condition will remain uncertain until further extensive investigations are undertaken, encompassing both pharmacological and non-pharmacological interventions.
References
Carl, E., Witcraft, S. M., Kauffman, B. Y., Gillespie, E. M., Becker, E. S., Cuijpers, P., Van Ameringen, M., Smits, J. A. 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
DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder. Annals of Internal Medicine, 170(7), ITC49. https://doi.org/10.7326/aitc201904020
Sartori, S. B., & Singewald, N. (2019). Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders. Pharmacology & Therapeutics, 204, 107402. https://doi.org/10.1016/j.pharmthera.2019.107402
Slee, A., Nazareth, I., Bondaronek, P., Liu, Y., Cheng, Z., & Freemantle, N. (2019). Pharmacological treatments for a generalized anxiety disorder: a systematic review and network meta-analysis. The Lancet, 393(10173), 768–777. https://doi.org/10.1016/s0140-6736(18)31793-8
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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.
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.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
Learning Resources
Required Readings
- 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)
Required Media
- Walden University, LLC. (Producer). (2019a). Adult geriatric depression
- Links to an external site. [Interactive media file]. Baltimore, MD: Author.
In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat adult geriatric depression.
- Walden University, LLC. (Producer). (2019c). Attention deficit hyperactivity disorder
- Links to an external site. [Interactive media file]. Baltimore, MD: Author.
In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat attention deficit hyperactivity disorder.
- Walden University, LLC. (Producer). (2019d). Bipolar therapy
- Links to an external site. [Interactive media file]. Baltimore, MD: Author.
In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics for bipolar therapy.
- Walden University, LLC. (Producer). (2019g). Generalized anxiety disorder
- Links to an external site. [Interactive media file]. Baltimore, MD: Author.
In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat generalized anxiety disorder.
- Speed Pharmacology. (2018). Pharmacology – Benzodiazepines, Barbiturates, Hypnotics (Made Easy)
- Links to an external site. [Video]. https://www.youtube.com/watch?v=4ZHudeMho8g&t=24s
Note: This media program is approximately 8 minutes
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.
By Day 6 of Week 8
Read a selection of your colleagues’ responses and respond to at least two of 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.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!
NURS_6521_Week8_Discussion_Rubric
| Criteria | Ratings | Pts | ||||
|---|---|---|---|---|---|---|
| This criterion is linked to a Learning Outcome Main Posting |
|
50 pts | ||||
| This criterion is linked to a Learning Outcome Main Post: Timeliness |
|
10 pts | ||||
| This criterion is linked to a Learning Outcome First Response |
|
18 pts | ||||
| This criterion is linked to a Learning Outcome Second Response |
|
17 pts | ||||
| This criterion is linked to a Learning Outcome Participation |
|
5 pts | ||||
| Total Points: 100 | ||||||