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 the 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.
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.
Assignment: Post a discussion of pharmacokinetics and pharmacodynamics related to anxiolytic medications used to treat Generalized Anxiety Disorder. In your discussion, utilizing the discussion highlights, compare and contrast different treatment options that can be used.
Pharmacology: Generalized Anxiety Disorder
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Pharmacology: Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is a psychological disorder that is commonly diagnosed among individuals of different age groups. According to Strawn et al. (2018), about 3-6% of adults and 5% of children in the United States have GAD. There are several FDA-approved and evidence-based anxiolytic medications for GAD treatment. This discussion will compare and contrast three classes of anxiolytic medications for GAD and describe the pharmacokinetic and pharmacodynamic processes that might affect patient outcomes. The first-line pharmacological interventions of GAD treatment are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) (Goodwin & Stein, 2021). However, the age factor might prevent children from responding effectively to these standard medications. the gamma-aminobutyric acid (GABA)-related interventions are commonly used to treat GAD in pediatric patients (Sonmez et al., 2020). SSRIs, SNRIs, and GABA-related interventions are similar in that their primary therapeutic effect is an improvement in GAD symptoms in the treated patients.
However, SSRIs, SNRIs, and GABA-related interventions have varied pharmacokinetic and pharmacodynamic processes. The mechanism of action of SSRIs entails the inhibition of the serotonin (5-hydroxytryptamine, 5-HT) reuptake transporter. SNRIs act by inhibiting norepinephrine reuptake at the synapse. Both SSRIs and SNRIs are well tolerated by individuals, are rapidly absorbed in the stomach, and have increased bioavailability. They are eliminated from the body through the kidney (Strawn et al., 2018; Goodwin & Stein, 2021). Pregabalin, a GABA-related drug, acts by binding to the α2δ subunit of brain voltage-gated calcium channels (N-type). This binding decreases presynaptic calcium currents leading to a reduction in calcium-dependent vesicle docking at the presynaptic membrane (Strawn et al. 2018). The rate of absorption of pregabalin is significantly decreased when the drug is administered with food (Strawn et al., 2018). In this respect, it is recommended that the drug be administered on an empty stomach for it to result in a clinically significant effect.
References
Goodwin, G. M., & Stein, D. J. (2021). Generalised anxiety disorder and depression: Contemporary treatment approaches. Advances in Therapy, 38(Suppl 2), 45–51. https://doi.org/10.1007/s12325-021-01859-8.
Sonmez, A. I., Almorsy, A., Ramsey, L. B., Strawn, J. R., & Croarkin, P. E. (2020). Novel pharmacological treatments for generalized anxiety disorder: Pediatric considerations. Depression and Anxiety, 37(8), 747–759. https://doi.org/10.1002/da.23038
Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert Opinion on Pharmacotherapy, 19(10), 1057–1070. https://doi.org/10.1080/14656566.2018.1491966.