Anxiety Disorders Treatment OptionsCompare and contrast treatment options for two anxiety disorders (choices include generalized anxiety disorder panic disorder social anxiety disorder and post-traumatic stress disorder). What should we consider before prescribing controlled substances and how should these be monitored when prescribed?

Purpose:

The purpose of required threaded discussions is an interactive dialogue among instructors and students to assist the student in organizing, integrating, applying, and critically appraising one’s knowledge regarding the nursing profession and selected area of practice. Scholarly information obtained from current sources as well as professional communication is required. The articles should have been published within the past 5 years and be peer-reviewed. In some cases, you will need to pull in content from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Application of information to advanced practice nursing experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life clinical situations. Interactive dialogue among instructors and peers fosters the development of a learning community as ideas, perspectives, and knowledge are shared. 

Managing Anxiety Disorders: Treatment Options and Considerations

Understanding Generalized Anxiety Disorder (GAD) and Panic Disorder (PD)

Anxiety disorders can affect daily life, causing excessive worry, fear, or panic. Two common anxiety disorders are Generalized Anxiety Disorder (GAD) and Panic Disorder (PD).

• GAD is characterized by persistent and excessive worry about everyday things. Symptoms often include muscle tension, restlessness, fatigue, difficulty concentrating, and trouble sleeping.
• PD involves sudden, intense panic attacks with symptoms like rapid heartbeat, shortness of breath, dizziness, and an overwhelming sense of fear or doom.

Treatment Options

The main treatment options for both disorders include medications and therapy:

1. Medications

   • First-line medications: SSRIs (e.g., sertraline, fluoxetine, escitalopram) and SNRIs (e.g., venlafaxine, duloxetine) help balance brain chemicals to reduce anxiety.
   • Alternative medications:
     • GAD: Buspirone and hydroxyzine may help if SSRIs or SNRIs are not effective.
     • PD: Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) may be used in difficult cases.
   • Benzodiazepines (e.g., lorazepam, clonazepam, alprazolam) may provide short-term relief for severe symptoms, but they have risks, including dependence.

2. Therapy

   • Cognitive Behavioral Therapy (CBT) helps people recognize and change negative thought patterns that cause anxiety.
   • Exposure Therapy is particularly effective for PD, helping patients gradually face their fears in a controlled environment.

Considerations Before Prescribing Controlled Substances

Benzodiazepines should be prescribed with caution because of their risk for dependence and withdrawal. Before prescribing them, healthcare providers should:

• Assess the patient’s history of substance use.
• Avoid long-term use, especially in elderly patients who are at higher risk of falls and confusion.
• Consider non-addictive options like SSRIs, SNRIs, or buspirone first.

Monitoring Controlled Substance Use

If benzodiazepines are prescribed, doctors should:

• Start with the lowest dose and monitor for side effects.
• Look for signs of misuse, such as requesting refills too soon. APA