What is the recommended treatment for Generalized Anxiety Disorder (GAD)? This is for advanced nursing pharmacology. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. (5th Ed.). American Psychiatric Association. American Psychological Association (2020). Publication manual of the American Psychological Association (7th ed.). American Psychological Association. https://doi.org/10.1037/0000165-000. Stahl, S. (2021). Stahl's essential psychopharmacology: Neuroscientific basis and practical application. 5th Ed. Cambridge University Press. Stahl, S. (2021). The prescriber′s guide: Stahl′s essential psychopharmacology. 7th Ed. Cambridge University Press. Stern, et al., (2018). Handbook of general hospital psychiatry (7th Ed.). Saunders. Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse. Springer Publishing Company, LLC.
Generalized Anxiety Disorder
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What is the recommended treatment for Generalized Anxiety Disorder (GAD)?
Generalized anxiety disorder can be treated using pharmacological interventions or psychotherapy. In most cases, the two treatment modalities are combined to achieve better outcomes (Stern et al., 2018). Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine and escitalopram are considered to be the first line of treatment. SSRIs’ therapeutic action involves increasing the level of serotonin in the brain, hence improving mood (Strawn et al., 2018). Serotonin plays a critical role in mood regulation, and individuals affected by a generalized anxiety disorder or depression are shown to have reduced levels of serotonin in their brain (Stahl, 2021). SSRIs act by blocking the serotonin transporter (SERT) located on the presynaptic axon terminal, preventing the reuptake of serotonin and increasing the activity of the neurotransmitter in the synaptic cleft for longer periods (Strawn et al., 2018). This improves the mood, hence the resolution of GAD symptoms. Serotonin-norepinephrine reuptake inhibitors such as Venlafaxine can also be used to manage GAD. This class of drugs acts by inhibiting the reuptake of serotonin and norepinephrine reuptake transporters, increasing the availability of these neurochemicals in the brain (Stahl, 2021).
Psychotherapy, including cognitive behavioral therapy, is also commonly used in the treatment and management of GAD (Wheeler, 2014). Cognitive behavioral therapy (CBT) involves a series of therapy sessions with a psychiatrist, with the aim of assisting the patient in developing healthy thinking patterns. CBT is founded on the concept that feelings, thoughts, and behaviors are interconnected; therefore, negative thinking patterns and feelings can cause individuals to express negative behaviors creating a negative cycle (Wheeler, 2014). Patients with GAD often experience excessive worry, which can impair their normal routine. The aim of CBT for such patients is to assist them in identifying the negative thought triggers and patterns and develop healthy thinking patterns to improve their behavior and feelings. Psychotherapy is often combined with pharmacological interventions for better results (Wheeler, 2014).
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References
Stahl, S. (2021). Stahlâ’s essential psychopharmacology: Neuroscientific basis and practical application. 5th Ed. Cambridge University Press.
Stern, et al., (2018). Handbook of general hospital psychiatry (7th Ed.). Saunders.
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. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340395/
Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse. Springer Publishing Company, LLC.