Treatment of Anxiety Disorders
General Treatment Approaches
TREATMENT OF ANXIETY DISORDERS
- Promote active coping
- MEDICATION: Provide information, directly moderate neurobiology
- COGNITIVE BEHAVIORAL TREATMENT: Provide information, Change neural circuitry through exposure, Teach specific coping techniques
Patient and Family Education
PATIENTS AND FAMILY NEED INFORMATION
- About the illness: symptoms and course
- Biological aspects of anxiety
- Psychological components of symptoms
- Simple principles of conditioned responses
- Role of thoughts and behaviors in affecting emotions
- Relationship between physiology, psychology and treatment
Pharmacological Treatment - Early Generation
PHARMACOLOGIC TREATMENT OF ANXIETY DISORDERS: EARLY GENERATION
- Typical Antidepressants, for example,
- imipramine,
- clomipramine,
- nortriptyline,
- monoamine oxidase Inhibitors (like phenelzine)
- Benzodiazepines (alprazolam, clonazepam)
- Most worked for some, but not all of the anxiety disorders
Selective Serotonin Reuptake Inhibitors (SSRIs) & Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
PHARMACOLOGIC TREATMENT OF ANXIETY DISORDERS: NEWER MEDICATIONS SSRIs and SNRIs
- citalopram
- fluoxetine
- fluvoxamine
- paroxetine
- sertraline
- Escitalopram
- Venlafaxine
- Doluxetine Act as “broad spectrum” antianxiety agents
Cognitive Behavioral Therapy (CBT) Efficacy
COGNITIVE BEHAVIORAL TREATMENTS ARE EQUALLY EFFICACIOUS AS MEDICATION FOR ANXIETY DISORDERS
- Preferred by many patients
- Associated with improvement in biological as well as psychological abnormalities
CBT Model of Panic Disorder
CBT MODEL OF PANIC DISORDER
Behavioral Anxiety Management Techniques
Behavioral Anxiety Management
- Decrease Physiological Arousal
- Slow Abdominal Breathing
- Progressive Muscle Relaxation
- Re-Instate Normal Activities
- Exposure to Anxiety Provoking Situations
Cognitive Therapy Techniques
Cognitive Therapy
- Target Negative Thinking and Logical Errors
- Overestimation of Probability of Negative Consequences
- Catastrophizing
- Techniques
- Identify and Challenge Negative Thoughts
- Provide Alternative Explanations