FDA-Approved Drug, Off-Label Drug, and Nonpharmacological Intervention for Treating the Disorder in Children and Adolescents
Generalized anxiety disorder treatment includes pharmacological treatment and non-pharmacological treatment. FDA-approved drugs include selective serotonin reuptake inhibitors, such as Sertraline and Escitalopram (Strawn et al., 2018). Sertraline is most commonly known as Zoloft, while Escitalopram is most commonly known as Lexapro. Both increase serotonin levels in the patient’s brain, which helps to manage anxiety symptoms (Strawn et al., 2018).
Serotonin reuptake inhibitors are mainly used for adult patients and should be prescribed to pediatric patients with caution (Strawn et al., 2018). One off-label drug that can be recommended for generalized anxiety treatment is buspirone (Kim et al., 2021). Buspirone also affects the levels of certain neurotransmitters, such as serotonin and dopamine (Kim et al., 2021). The regulation of both helps to mitigate anxiety symptoms in a similar but milder way. While selective serotonin reuptake inhibitors are also used to treat depression, buspirone is primarily prescribed as an anxiety medication.
One of the most effective non-pharmaceutical treatments for generalized anxiety is cognitive-behavioral therapy (CBT). CBT helps patients change negative thought patterns and convictions that typically cause anxiety (Daitch, 2018). CBT has been proven to be highly effective and to have long-lasting effects on patients (Daitch, 2018). It can be used for patients of all ages, regardless of their health status and medical history.
Risk Assessment for Treatment Decision Making: Risks and Benefits of FDA-Approved and Off-Label Drugs
To conduct a thorough risk assessment and choose an appropriate treatment option, one must evaluate an individual’s medical history, current medications, and other factors affecting a patient’s health. After the evaluation has been conducted, the treatment can be assigned. There are several benefits of selective serotonin reuptake inhibitors. The first one is their effectiveness in treating patients with severe symptoms of anxiety, as both Zoloft and Lexapro are effective in these cases (Ströhleet al, 2018). These medications are also generally well tolerated by patients.
On the other hand, there are potential side effects and risks. These include dizziness, nausea, and sexual dysfunction in patients of both sexes (Strawn et al., 2018). There is also a risk of the drugs interacting with other medications and food products.
Buspirone has fewer side effects and fewer risks than FDA-approved drugs overall. However, it is considered to be less effective when it comes to severe anxiety cases. Buspirone can also interact with other medications and food products, such as grape juice (Kim et al., 2021). Overall, the medication should be chosen based on the severity of the symptoms and the medical history of the assessed individual.
Clinical Practice Guidelines for the Disorder and Justification for Treatment Recommendations
American Psychiatric Association has specific clinical practice guidelines for the treatment of generalized anxiety disorder. The guidelines indicate using cognitive-behavioral therapy and pharmaceuticals separately or combined. In particular, the guidelines mention selective serotonin reuptake inhibitors such as Zoloft and Lexapro as first-line treatments (DeMartini et al., 2019).
On the other hand, the guidelines also include the possible use of Buspirone for milder anxiety cases. Therefore, the recommended treatment would include the use of cognitive-behavioral therapy and selective serotonin inhibitors for patients with severe cases of the disorder. If the symptoms are not as severe, Buspirone can be prescribed in combination with CBT. In the cases where pharmaceuticals cannot be prescribed for one reason or another, CBT can be applied as a separate form of treatment.
References
Daitch, C. (2018). Cognitive behavioral therapy, mindfulness, and hypnosis as treatment methods for generalized anxiety disorder. American Journal of Clinical Hypnosis, 61(1), 57-69. Web.
DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized anxiety disorder. Annals of Internal Medicine. Web.
Kim, J. K., Han, S. K., Joo, M. K. & Kim, D. H. (2021). Buspirone alleviates anxiety, depression, and colitis; and modulates gut microbiota in mice. ScientificReports, 11. Web.
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. Web.
Ströhle, A., Gensichen, J., & Domschke, K. (2018). The diagnosis and treatment of anxiety disorders. DeutschesArzteblatt international, 155(37), 611–620. Web.
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