Anxiety Disorder: Pharmacology Essay

Introduction. Pathophysiology of Anxiety Disorder

• Anxiety causes fear, insomnia, chronic pain, premonition, difficulty concentrating, the effectiveness of selective serotonin reuptake inhibitors (SSRIs), and more.
• The key point – sympathoadrenal, is associated with hypothalamic-pituitary-adrenal hyperreactivity.
• An increase in the concentration of ACTH and cortisol (Anxiety disorder).
• Anxiety decreases the brain-derived neurotrophic factor (BDNF).

Anxiety Disorder Treatment

• Treatment should not be self-administered
• The disorder regulatory effect on neurotransmitter systems, mainly serotonin (Anxiety disorder).
• Together with the norepinephrine and dopamine systems, the concentration of ACTH and cortisol provides an adequate emotional response to the body.
• Usually, 9-12 months of therapy is required to achieve complete remission
• The appointment of medicines begins with half the starting dose with a gradual increase in dosage after a week to the standard dose

Definitions of the Two Drug (medication) Classes used for Anxiety Disorder

• Drugs of selective serotonin reuptake inhibitors (SSRIs) help in anxiety treatment (Anxiety disorder).
• SSRIs have a pathogenetic therapeutic focus.
• Tranquilizers: maximum two weeks at the start of therapy.
• Prescribing tranquilizers is warranted for a maximum of 2 weeks when initiating SSRI treatment to avoid increased anxiety during the first week of SSRIs (Anxiety disorder).
• Medicines prescribed by a doctor.

Discussion of Medications

• Examples of SSRIs: citalopram (Celexa), fluoxetine (Prozac).
• Celexa stimulates synaptogenesis processes, restoring autophagy signals, and improving tissue immunoregulation with inhibition of immunogenic cytotoxicity of macrophages (Citalopram).
• An analog is Prozac, the mechanism of action in the central nervous system, which block the reverse neuronal uptake of serotonin selectively (Fluoxetine).
• Examples of tranquilizers: alprazolam (Xanax), clonazepam (Klonopin).
• Xanax has a sedative, central muscle relaxant, anticonvulsant, hypnotic, anxiolytic, effect. It reduces the impact of motor, vegetative, emotive and helps the body in falling asleep (Alprazolam).
• The anxiolytic effect of Klonopin is obtained as a result of the impact on the amygdala complex of the limbic system (Clonazepam). It is manifested in decreased fear, emotional stress, weakening and general anxiety.

Pharmacokinetics, Pharmacodynamics & Pregnancy/Lactation of Celexa

• Celexa dissolves in the liver.
• The action of the drug occurs because of central inhibition of serotonin reuptake.
• Celexa has a strong effect on the heart and gastrointestinal tract, thus requires for ECG and/or monitoring of electrolytes.
• Approved for use during pregnancy and lactation.
• It has side effects include poor feeding, colic, and unusual drowsiness, irritability, or restlessness in a minimal number of children.

Pharmacokinetics, Pharmacodynamics, & Pregnancy/Lactation of Prozac

• Absorbed from the gastrointestinal tract.
• Delays the reverse capture of serotonin.
• Monitoring is required.
• Approved for use during pregnancy and lactation.
• It increases the risk of genetic heart defects in the fetus, premature birth, and weight loss in a baby (Fluoxetine).

Pregnancy/Lactation during treatment for SSRIs

• Approved for use during pregnancy and lactation.
• It increases the risk of genetic heart defects in the fetus.
• Medicines may cause premature birth.
• In addition, weight loss in a baby is often.
• Passes into milk, so may affect the baby.

Pregnancy/Lactation during treatment for Tranquilizers

• Pregnancy and lactation are contraindicated.
• Easily crosses the placenta.
• Exceeds the concentration of diazepam in maternal blood.
• Increases the incidence of birth defects in children.
• Passes into milk, so may affect the baby.

Safety/Monitoring of Medications

• Monitoring is required at any stage of the disease.
• The medicine is prescribed by a doctor.
• Additional medications are carried out if necessary.
• Stop taking medications only on doctor’s orders.
• Completely individual dosage.

Pharmacokinetics, Pharmacodynamics of Xanax

• Absorbed from the gastrointestinal tract.
• Binds γ-aminobutyric acid (GABA) type A receptors (GABA AR).
• Completely individual dosage, therefore, requires monitoring and consultation with a doctor.
• Alprazolam has a harmful effect on the fetus and raises the possibility of congenital malformations when used in the first three months of pregnancy, thus, prohibited during pregnancy (Alprazolam).
• May cause drowsiness in newborns.
• Makes breastfeeding difficult.

Pharmacokinetics, Pharmacodynamic of Klonopin

• Plasma protein binding.
• The activity of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the central nervous system.
• Completely individual dosage, therefore, requires monitoring and consultation with a doctor.
• Pregnancy and lactation are contraindicated.

Contraindications of the 4 Medications Discussed Earlier

• Each drug has its characteristics and contraindications, so one needs to consult a doctor.
• General contraindications include allergy, heart problems, problems with the gastrointestinal tract.
• Tranquilizers are prohibited if a person has glaucoma and diseases of the respiratory system.
• Long-term use is not justified because of the possibility of drug dependence.
• In addition, after the abolition of drugs in this group, the return of painful symptoms occurs since the main pathophysiological mechanisms associated with impaired serotonin mediation are not resolved.

Conclusions

• Anxiety disorder has different treatments.
• It requires individual treatment.
• Any drug must be prescribed by a doctor.
• The drugs are taken only under the supervision of the attending physician.
• One should always be aware of side effects and contraindications.

References

Alprazolam. WebMD. (n.d.).

Anxiety disorder treatment & medications. WebMD. (n.d.).

Citalopram. NHS. (n.d.).

Clonazepam. NHS. (n.d.).

Fluoxetine. NHS. (n.d.).