Potential Impacts of Pharmacotherapeutics Used in the Treatment of GAD

Potential Impacts of Pharmacotherapeutics Used in the Treatment of GAD

Various classes of medications have been proven to have efficacy in managing and treating Generalized Anxiety Disorder (GAD). These include selective serotonin and selective norepinephrine reuptake inhibitors (SSRIs and SNRIs), benzodiazepines, azapirones, anti-adrenergic medications, melatonin analogs, and second-generation antipsychotics (SGAs) (Strawn et al., 2018). SSRIs and SNRIs can be administered as first-line psychopharmacologic treatment, while benzodiazepines and SGAs, among other classes, can be used as second-line pharmacotherapies in adults. As all potential pharmacotherapeutic options have shown to have a higher level of efficacy in GAD treatment, it is important to evaluate the potential drug effects of the distinct classes.

Most medications in the SSRIs and SNRIs classes are well-tolerated (Wang et al., 2018). However, SSRIs and SNRIs such as clozapine, olanzapine, risperidone, sertindole, and aripiprazole have been linked to cardiovascular effects, including orthostatic hypotension (Pacher & Kecskemeti, 2005). Other serious effects include sexual dysfunction (Schweitzer et al., 2009) and hepatoxicity (Wang et al., 2018). Second-generation antipsychotic (SGA) use is related to metabolic side effects. SGAs such as olanzapine and risperidone may lead to adverse metabolic side effects, including weight gain and a higher risk of diabetes mellitus (Stogios et al., 2021).

Moreover, benzodiazepines, including remimazolam, 3-hydroxyphenazapam, adinazolam, clonazolam, and deschloroetizolam are linked to memory problems, suicidality, delirium, and increased risk of the patient becoming dependent on the medication after prolonged use (Cornett et al., 2018). In extreme cases, patients who prolong the use of anti-adrenergic medications such as clonidine and guanfacine experience bradycardia, hypotension, hyperglycemia, and hypodynamic shock. All classes of antidepressants used in the treatment of GAD have common side effects, including nausea, tiredness, dizziness, confusion, drowsiness, loss of appetite, and increased anxiety.

References

Cornett, E. M., Novitch, M. B., Brunk, A. J., Davidson, K. S., Menard, B. L., Urman, R. D., & Kaye, A. D. (2018). New benzodiazepines for sedation. Best Practice & Research Clinical Anaesthesiology, 32(2), 149–164. https://doi.org/10.1016/J.BPA.2018.06.007

Pacher, P., & Kecskemeti, V. (2005). Cardiovascular Side Effects of New Antidepressants and Antipsychotics: New Drugs, old Concerns? Current Pharmaceutical Design, 10(20), 2463–2475. https://doi.org/10.2174/1381612043383872

Schweitzer, I., Maguire, K., & Ng, C. (2009). Sexual side-effects of contemporary antidepressants: Review. Australian and New Zealand Journal of Psychiatry, 43(9), 795–808. https://doi.org/10.1080/00048670903107575

Stogios, N., Smith, E., Bowden, S., Tran, V., Asgariroozbehani, R., McIntyre, W. B., Remington, G., Siskind, D., Agarwal, S. M., & Hahn, M. K. (2021). Metabolic adverse effects of off-label use of second-generation antipsychotics in the adult population: a systematic review and meta-analysis. Neuropsychopharmacology, 47(3), 664–672. https://doi.org/10.1038/s41386-021-01163-7

Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for Generalized Anxiety Disorder in Adults and Pediatric Patients: An Evidence-Based Treatment Review. Expert Opinion on Pharmacotherapy, 19(10), 1057. https://doi.org/10.1080/14656566.2018.1491966

Wang, S.-M., Han, C., Bahk, W.-M., Lee, S.-J., Patkar, A. A., Masand, P. S., & Pae, C.-U. (2018). Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review. Chonnam Medical Journal, 54(2), 101. https://doi.org/10.4068/CMJ.2018.54.2.101

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WK 8 Discussion: 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.

Potential Impacts of Pharmacotherapeutics 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.

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.