Treatments for Anxiety Disorders
Treatment list for Anxiety Disorders:
The list of treatments mentioned in various sources
for Anxiety Disorders
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Anxiety Disorders: Research Doctors & Specialists
Research all specialists including ratings, affiliations, and sanctions.
Drugs and Medications used to treat Anxiety Disorders:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Anxiety Disorders include:
Latest treatments for Anxiety Disorders:
The following are some of the latest treatments for Anxiety Disorders:
Medical news summaries about treatments for Anxiety Disorders:
The following medical news items
are relevant to treatment of Anxiety Disorders:
Discussion of treatments for Anxiety Disorders:
Anxiety Disorders: NWHIC (Excerpt)
Many people misunderstand these disorders and think
individuals should be able to overcome the symptoms by sheer willpower.
Wishing the symptoms away does not work -- but there are very effective
treatments that can help. (Source: excerpt from Anxiety Disorders: NWHIC)
Anxiety Disorders: NWHIC (Excerpt)
If you, or someone you know, has symptoms of anxiety,
a visit to the family physician is usually the best place to start. A
physician can help you determine whether the symptoms are due to an
anxiety disorder, some other medical condition, or both. Most often, the
next step is to get treatment for an anxiety disorder from a mental health
professional.
Among the professionals who can help are psychiatrist,
psychologists, social workers, and counselors. However, it’s best to look
for a professional who has specialized training in cognitive-behavioral or
behavioral therapy and who is open to the use of medications should they
be needed.
Psychologists, social workers, and counselors
sometimes work closely with a psychiatrist or another physician, who will
prescribe medications when they are required. For some people, group
therapy or self-help groups are a helpful part of treatment. Many people
do best with a combination of these therapies.
When you’re looking for a health care professional,
it’s important to inquire about what kinds of therapy she or he generally
uses or whether medications are available. It’s important that you feel
comfortable with the therapy. If this is not the case, seek help
elsewhere. However, if you’ve been taking medication, it’s important not
to quit certain drugs abruptly, but to taper them off under the
supervision of your physician. Be sure to ask your physician about how to
stop a medication.
Remember, though, that when you find a health care
professional you’re satisfied with, the two of you are working as a team.
Together you will be able to develop a plan to treat your anxiety disorder
that may involve medications, behavioral therapy, or cognitive-behavioral
therapy, as appropriate. Treatments for anxiety disorders, however, may
not start working instantly. Your doctor or therapist may ask you to
follow a specific treatment plan for several weeks to determine whether
it’s working.
(Source: excerpt from Anxiety Disorders: NWHIC)
Anxiety Disorders Research at the National Institute of Mental Health: NIMH (Excerpt)
More medications are available than ever before to effectively
treat anxiety disorders. These include antidepressants and
benzodiazepines. If one medication is not effective, others can be
tried. New medications are currently being tested or are under
development to treat anxiety symptoms.
The two most effective forms of psychotherapy used to treat
anxiety disorders are behavioral therapy and cognitive-behavioral
therapy. Behavioral therapy tries to change actions through
techniques such as diaphragmatic breathing or through gradual
exposure to what is frightening. In addition to these techniques,
cognitive-behavioral therapy teaches patients to understand their
thinking patterns so they can react differently to the situations
that cause them anxiety. (Source: excerpt from Anxiety Disorders Research at the National Institute of Mental Health: NIMH)
Anxiety Disorders: NIMH (Excerpt)
In
general, two types of treatment are available for an anxiety
disorder-medication and specific types of psychotherapy (sometimes called
"talk therapy"). Both approaches can be effective for most disorders. The
choice of one or the other, or both, depends on the patient's and the
doctor's preference, and also on the particular anxiety disorder. For
example, only psychotherapy has been found effective for specific phobias.
When choosing a therapist, you should find out whether medications will be
available if needed.
Before treatment can begin, the doctor must conduct a careful
diagnostic evaluation to determine whether your symptoms are due to an
anxiety disorder, which anxiety disorder(s) you may have, and what
coexisting conditions may be present. Anxiety disorders are not all
treated the same, and it is important to determine the specific problem
before embarking on a course of treatment. Sometimes alcoholism or some
other coexisting condition will have such an impact that it is necessary
to treat it at the same time or before treating the anxiety disorder.
If you have been treated previously for an anxiety disorder, be
prepared to tell the doctor what treatment you tried. If it was a
medication, what was the dosage, was it gradually increased, and how long
did you take it? If you had psychotherapy, what kind was it, and how often
did you attend sessions? It often happens that people believe they have
"failed" at treatment, or that the treatment has failed them, when in fact
it was never given an adequate trial.
When you undergo treatment for an anxiety disorder, you and your doctor
or therapist will be working together as a team. Together, you will
attempt to find the approach that is best for you. If one treatment
doesn't work, the odds are good that another one will. And new treatments
are continually being developed through research. So don't give up
hope.
(Source: excerpt from Anxiety Disorders: NIMH)
Anxiety Disorders: NIMH (Excerpt)
Psychiatrists or other physicians can prescribe medications for anxiety
disorders. These doctors often work closely with psychologists, social
workers, or counselors who provide psychotherapy. Although medications
won't cure an anxiety disorder, they can keep the symptoms under control
and enable you to lead a normal, fulfilling life.
The major classes of medications used for various anxiety disorders are
described below.
Antidepressants
A number of medications that were originally
approved for treatment of depression have been found to be effective for
anxiety disorders. If your doctor prescribes an antidepressant, you will
need to take it for several weeks before symptoms start to fade. So it is
important not to get discouraged and stop taking these medications before
they've had a chance to work.
Some of the newest antidepressants are called selective serotonin
reuptake inhibitors, or SSRIs. These medications act in the
brain on a chemical messenger called serotonin. SSRIs tend to have fewer
side effects than older antidepressants. People do sometimes report
feeling slightly nauseated or jittery when they first start taking SSRIs,
but that usually disappears with time. Some people also experience sexual
dysfunction when taking some of these medications. An adjustment in dosage
or a switch to another SSRI will usually correct bothersome problems. It
is important to discuss side effects with your doctor so that he or she
will know when there is a need for a change in medication.
Fluoxetine, sertraline, fluvoxamine, paroxetine, and citalopram are
among the SSRIs commonly prescribed for panic disorder, OCD, PTSD, and
social phobia. SSRIs are often used to treat people who have panic
disorder in combination with OCD, social phobia, or depression.
Venlafaxine, a drug closely related to the SSRIs, is useful for treating
GAD. Other newer antidepressants are under study in anxiety disorders,
although one, bupropion, does not appear effective for these conditions.
These medications are started at a low dose and gradually increased until
they reach a therapeutic level.
Similarly, antidepressant medications called tricyclics are
started at low doses and gradually increased. Tricyclics have been around
longer than SSRIs and have been more widely studied for treating anxiety
disorders. For anxiety disorders other than OCD, they are as effective as
the SSRIs, but many physicians and patients prefer the newer drugs because
the tricyclics sometimes cause dizziness, drowsiness, dry mouth, and
weight gain. When these problems persist or are bothersome, a change in
dosage or a switch in medications may be needed.
Tricyclics are useful in treating people with co-occurring anxiety
disorders and depression. Clomipramine, the only antidepressant in its
class prescribed for OCD, and imipramine, prescribed for panic disorder
and GAD, are examples of tricyclics.
Monoamine oxidase inhibitors, or MAOIs, are the oldest
class of antidepressant medications. The most commonly prescribed MAOI is
phenelzine, which is helpful for people with panic disorder and social
phobia. Tranylcypromine and isoprocarboxazid are also used to treat
anxiety disorders. People who take MAOIs are put on a restrictive diet
because these medications can interact with some foods and beverages,
including cheese and red wine, which contain a chemical called tyramine.
MAOIs also interact with some other medications, including SSRIs.
Interactions between MAOIs and other substances can cause dangerous
elevations in blood pressure or other potentially life-threatening
reactions.
Anti-Anxiety Medications
High-potency benzodiazepines
relieve symptoms quickly and have few side effects, although drowsiness
can be a problem. Because people can develop a tolerance to them-and would
have to continue increasing the dosage to get the same
effect-benzodiazepines are generally prescribed for short periods of time.
One exception is panic disorder, for which they may be used for 6 months
to a year. People who have had problems with drug or alcohol abuse are not
usually good candidates for these medications because they may become
dependent on them.
Some people experience withdrawal symptoms when they stop taking
benzodiazepines, although reducing the dosage gradu-ally can diminish
those symptoms. In certain instances, the symptoms of anxiety can rebound
after these medications are stopped. Potential problems with
benzodiazepines have led some physicians to shy away from using them, or
to use them in inadequate doses, even when they are of potential benefit
to the patient. Benzodiazepines include clonazepam, which is used for
social phobia and GAD; alprazolam, which is helpful for panic disorder and
GAD; and lorazepam, which is also useful for panic disorder.
Buspirone, a member of a class of drugs called azipirones, is a newer
anti-anxiety medication that is used to treat GAD. Possible side effects
include dizziness, headaches, and nausea. Unlike the benzodiazepines,
buspirone must be taken consistently for at least two weeks to achieve an
anti-anxiety effect.
Other Medications
Beta-blockers, such as propanolol, are
often used to treat heart conditions but have also been found to be
helpful in certain anxiety disorders, particularly in social phobia. When
a feared situation, such as giving an oral presentation, can be predicted
in advance, your doctor may prescribe a beta-blocker that can be taken to
keep your heart from pounding, your hands from shaking, and other physical
symptoms from developing. (Source: excerpt from Anxiety Disorders: NIMH)
Anxiety Disorders: NIMH (Excerpt)
Psychotherapy involves talking with a trained mental health
professional, such as a psychiatrist, psychologist, social worker, or
counselor to learn how to deal with problems like anxiety disorders.
Cognitive-Behavioral and Behavioral Therapy
Research has
shown that a form of psychotherapy that is effective for several anxiety
disorders, particularly panic disorder and social phobia, is
cognitive-behavioral therapy (CBT). It has two components. The
cognitive component helps people change thinking patterns that keep
them from overcoming their fears. For example, a person with panic
disorder might be helped to see that his or her panic attacks are not
really heart attacks as previously feared; the tendency to put the worst
possible interpretation on physical symptoms can be overcome. Similarly, a
person with social phobia might be helped to overcome the belief that
others are continually watching and harshly judging him or her.
The behavioral component of CBT seeks to change people's
reactions to anxiety-provoking situations. A key element of this component
is exposure, in which people confront the things they fear. An
example would be a treatment approach called exposure and response
prevention for people with OCD. If the person has a fear of dirt and
germs, the therapist may encourage them to dirty their hands, then go a
certain period of time without washing. The therapist helps the patient to
cope with the resultant anxiety. Eventually, after this exercise has been
repeated a number of times, anxiety will diminish. In another sort of
exposure exercise, a person with social phobia may be encouraged to spend
time in feared social situations without giving in to the temptation to
flee. In some cases the individual with social phobia will be asked to
deliberately make what appear to be slight social blunders and observe
other people's reactions; if they are not as harsh as expected, the
person's social anxiety may begin to fade. For a person with PTSD,
exposure might consist of recalling the traumatic event in detail, as if
in slow motion, and in effect re-experiencing it in a safe situation. If
this is done carefully, with support from the therapist, it may be
possible to defuse the anxiety associated with the memories. Another
behavioral technique is to teach the patient deep breathing as an aid to
relaxation and anxiety management.
Behavioral therapy alone, without a strong cognitive compo-nent, has
long been used effectively to treat specific phobias. Here also, therapy
involves exposure. The person is gradually exposed to the object or
situation that is feared. At first, the exposure may be only through
pictures or audiotapes. Later, if possible, the person actually confronts
the feared object or situation. Often the therapist will accompany him or
her to provide support and guidance.
If you undergo CBT or behavioral therapy, exposure will be carried out
only when you are ready; it will be done gradually and only with your
permission. You will work with the therapist to determine how much you can
handle and at what pace you can proceed.
A major aim of CBT and behavioral therapy is to reduce anxiety by
eliminating beliefs or behaviors that help to maintain the anxiety
disorder. For example, avoidance of a feared object or situation prevents
a person from learning that it is harmless. Similarly, performance of
compulsive rituals in OCD gives some relief from anxiety and prevents the
person from testing rational thoughts about danger, contamination,
etc.
To be effective, CBT or behavioral therapy must be directed at the
person's specific anxieties. An approach that is effective for a person
with a specific phobia about dogs is not going to help a person with OCD
who has intrusive thoughts of harming loved ones. Even for a single
disorder, such as OCD, it is necessary to tailor the therapy to the
person's particular concerns. CBT and behavioral therapy have no adverse
side effects other than the temporary discomfort of increased anxiety, but
the therapist must be well trained in the techniques of the treatment in
order for it to work as desired. During treatment, the therapist probably
will assign "homework" -- specific problems that the patient will need to
work on between sessions.
CBT or behavioral therapy generally lasts about 12 weeks. It may be
conducted in a group, provided the people in the group have sufficiently
similar problems. Group therapy is particularly effective for people with
social phobia. There is some evidence that, after treatment is terminated,
the beneficial effects of CBT last longer than those of medications for
people with panic disorder; the same may be true for OCD, PTSD, and social
phobia.
Medication may be combined with psychotherapy, and for many people this
is the best approach to treatment. As stated earlier, it is important to
give any treatment a fair trial. And if one approach doesn't work, the
odds are that another one will, so don't give up.
If you have recovered from an anxiety disorder, and at a later date it
recurs, don't consider yourself a "treatment failure." Recurrences can be
treated effectively, just like an initial episode. In fact, the skills you
learned in dealing with the initial episode can be helpful in coping with
a setback. (Source: excerpt from Anxiety Disorders: NIMH)
Anxiety Disorders: NIMH (Excerpt)
Many people with anxiety disorders benefit from joining a self-help
group and sharing their problems and achievements with others. Talking
with trusted friends or a trusted member of the clergy can also be very
helpful, although not a substitute for mental health care. Participating
in an Internet chat room may also be of value in sharing concerns and
decreasing a sense of isolation, but any advice received should be viewed
with caution.
The family is of great importance in the recovery of a person with an
anxiety disorder. Ideally, the family should be supportive without helping
to perpetuate the person's symptoms. If the family tends to trivialize the
disorder or demand improvement without treatment, the affected person will
suffer. You may wish to show this booklet to your family and enlist their
help as educated allies in your fight against your anxiety disorder.
Stress management techniques and meditation may help you to calm
yourself and enhance the effects of therapy, although there is as yet no
scientific evidence to support the value of these "wellness" approaches to
recovery from anxiety disorders. There is preliminary evidence that
aerobic exercise may be of value, and it is known that caffeine, illicit
drugs, and even some over-the-counter cold medications can aggravate the
symptoms of an anxiety disorder. Check with your physician or pharmacist
before taking any additional medicines. (Source: excerpt from Anxiety Disorders: NIMH)
Facts About Anxiety Disorders: NIMH (Excerpt)
A number of medications that were originally approved for treating
depression have been found to be effective for anxiety disorders as well.
Some of the newest of these antidepressants are called selective serotonin
reuptake inhibitors (SSRIs). Other antianxiety medications include groups
of drugs called benzodiazepines and beta-blockers. If one medication is
not effective, others can be tried. New medications are currently under
development to treat anxiety symptoms.
Two clinically-proven effective forms of psychotherapy used to treat
anxiety disorders are behavioral therapy and cognitive-behavioral therapy.
Behavioral therapy focuses on changing specific actions and uses several
techniques to stop unwanted behaviors. In addition to the behavioral
therapy techniques, cognitive-behavioral therapy teaches patients to
understand and change their thinking patterns so they can react
differently to the situations that cause them anxiety.
(Source: excerpt from Facts About Anxiety Disorders: NIMH)
Facts About Anxiety Disorders: NIMH (Excerpt)
Many people misunderstand anxiety disorders and other mental
illnesses and think individuals should be able to overcome the symptoms
by sheer willpower. Wishing the symptoms away does not work-but there
are treatments that can help. Treatment for anxiety disorders often
involves medication, specific forms of psychotherapy, or a combination
of the two. (Source: excerpt from Facts About Anxiety Disorders: NIMH)
Medications: NIMH (Excerpt)
Both antidepressants and antianxiety medications are used to treat
anxiety disorders. The broad-spectrum activity of most antidepressants
provides effectiveness in anxiety disorders as well as depression. The
first medication specifically approved for use in the treatment of OCD was
the tricyclic antidepressant clomipramine (Anafranil). The SSRIs,
fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine
(Paxil), and sertraline (Zoloft) have now been approved for
use with OCD. Paroxetine has also been approved for social anxiety
disorder (social phobia), GAD, and panic disorder; and sertraline is
approved for panic disorder and PTSD. Venlafaxine (Effexor) has
been approved for GAD.
Antianxiety medications include the benzodiazepines, which can relieve
symptoms within a short time. They have relatively few side effects:
drowsiness and loss of coordination are most common; fatigue and mental
slowing or confusion can also occur. These effects make it dangerous for
people taking benzodiazepines to drive or operate some machinery. Other
side effects are rare. (Source: excerpt from Medications: NIMH)
Medications: NIMH (Excerpt)
The only medication specifically for anxiety disorders other than the
benzodiazepines is buspirone (BuSpar). Unlike the benzodiazepines,
buspirone must be taken consistently for at least 2 weeks to achieve an
antianxiety effect and therefore cannot be used on an "as-needed"
basis.
Beta blockers, medications often used to treat heart conditions and
high blood pressure, are sometimes used to control "performance anxiety"
when the individual must face a specific stressful situation--a speech, a
presentation in class, or an important meeting. Propranolol (Inderal,
Inderide) is a commonly used beta blocker. (Source: excerpt from Medications: NIMH)
Treatments of Anxiety Disorders: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the treatments of Anxiety Disorders.
Anxiety:
Treatment
(In a Page: Signs and Symptoms)
-
Patient education regarding available treatment and reassurance often has a calming effect
-
Treatment usually combines pharmacologic and nonpharmacologic approaches, including cognitive-behavioral therapy, relaxation training, and biofeedback
-
General anxiety disorder: Cognitive therapy has been proven to be beneficial; benzodiazepines, buspirone, and antidepressants (tricyclic antidepressants, SSRIs) are all effective; however, concern over dependence sometimes limits the use of benzodiazepines
-
Panic disorder: SSRIs, tricyclic antidepressants, benzodiazepines, and cognitive-behavioral therapy are equivalently effective
-
Obsessive-compulsive disorder: High-dose SSRIs and cognitive-behavioral therapy are effective
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Fontanel depression:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If you detect a markedly depressed fontanel, take the infant’s vital signs, weigh him, and check for signs of shock — tachycardia, tachypnea, and cool, clammy skin. If these signs are present, insert an I.V. line and administer fluids. Have size-appropriate emergency equipment on hand. Anticipate oxygen administration. Monitor urine output by weighing wet diapers.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Generalized anxiety disorder:
Treatment
(Professional Guide to Diseases (Eighth Edition))
A combination of drug therapy and psychotherapy may help a patient with generalized anxiety disorder. Benzodiazepines may relieve mild anxiety and improve the patient’s ability to cope.
ELDER TIP A benzodiazepine with a long half-life tends to accumulate in an older patient’s system and may cause oversedation. Benzodiazepines are sometimes given along with opioids to add to the analgesic effect or as a preanesthetic. Remember, if the elderly psychiatric patient is scheduled for surgery, he may take longer to recover from anesthesia if these combinations are used.
Tricyclic antidepressants or higher doses of short-acting benzodiazepines may relieve severe anxiety and panic attacks. Buspirone, an antianxiety drug, causes the patient less sedation and poses less risk of physical and psychological dependence than the benzodiazepines.
Psychotherapy for generalized anxiety disorder has two goals: helping the patient identify and deal with the cause of the anxiety and eliminating environmental factors that precipitate an anxious reaction. In addition, the patient can learn relaxation techniques, such as deep breathing, progressive muscle relaxation, focused relaxation, and visualization.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Major depression:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Depression is difficult to treat, especially in children, adolescents, elderly patients, and those with a history of chronic disease. The primary treatment methods are drug therapy and psychotherapy, particularly cognitive behavioral therapy.
Drug therapy includes tricyclic antidepressants (TCAs) such as amitriptyline, monoamine oxidase (MAO) inhibitors such as isocarboxazid, maprotiline, and trazodone, which has been available for 40 years. A newer class of drugs, the selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, paroxetine, sertraline, bupropion, venlafaxine, and mirtazapine, are equally effective and have more tolerable adverse effect profiles.
TCAs, the most widely used class of antidepressant drugs, prevent the reuptake of norepinephrine or serotonin (or both) into the presynaptic nerve endings, resulting in increased synaptic concentrations of these neurotransmitters. They also cause a gradual loss in the number of beta-adrenergic receptors.
MAO inhibitors block the enzymatic degradation of norepinephrine and serotonin. These agents commonly are prescribed for patients with atypical depression (for example, depression marked by an increased appetite and need for sleep, rather than anorexia and insomnia) and for some patients who fail to respond to TCAs. MAO inhibitors are associated with a high risk of toxicity; patients treated with one of these drugs must be able to comply with the necessary dietary restrictions.
Maprotiline is a potent blocker of norepinephrine uptake, whereas trazodone is an SSRI. The mechanism of action of bupropion is unknown.
Electroconvulsive therapy (ECT) may be considered in particularly severe or drug-resistant depression. Six to 12 treatments are typically needed, although in many cases improvement is evident after only a few treatments. However, ECT has been associated with later short-term memory loss, heart arrhythmias, and seizure activity. Researchers hypothesize that ECT affects the same receptor sites as antidepressants.
Short-term psychotherapy is also effective in treating major depression. Many psychiatrists believe that the best results are achieved with a combination of individual, family, or group psychotherapy and medication. After resolution of the acute episode, patients with a history of recurrent depression may be maintained on low doses of antidepressants as a preventive measure.
Depression may be experienced differently by members of different cultures. For instance, in some Asian cultures, there are more somatic manifestations of depression than overt psychologic signs or symptoms.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Fontanel depression:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If you detect a markedly depressed fontanel, take vital signs, weigh the infant, and check for signs of shock—tachycardia, tachypnea, and cool, clammy skin. If these signs are present, insert an I.V. line and administer fluids. Have size-appropriate emergency equipment on hand. Anticipate oxygen administration. Monitor urine output by weighing the wet diapers.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Anxiety disorder, generalized:
Treatment
(Handbook of Diseases)
A combination of drug therapy and psychotherapy may help a patient with generalized anxiety disorder. Benzodiazepine anxiolytics relieve mild anxiety and improve the patient’s ability to cope. They should be used cautiously, however, because they can be addictive. Buspirone, a nonbenzodiazepine anxiolytic, is an alternative to the benzodiazepines because it causes less sedation and poses less risk of physical and psychological dependence.
Psychotherapy for generalized anxiety disorder has two goals: helping the patient identify and deal with the underlying emotional and psychological issues and eliminating environmental factors that precipitate an anxious reaction. In addition, the patient can learn relaxation techniques, such as deep breathing, progressive muscle relaxation, focused relaxation, and visualization.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Depression, major:
Treatment
(Handbook of Diseases)
Depression is difficult to treat, especially in children, adolescents, elderly patients, and those with a history of chronic disease. The primary treatment methods are drug therapy, electroconvulsive therapy (ECT), and psychotherapy.
Drug therapy
In depression, drug therapy includes tricyclic antidepressants (TCAs) such as amitriptyline, serotonin reuptake inhibitors such as fluoxetine, and monoamine oxidase (MAO) inhibitors, such as isocarboxazid, maprotiline, and trazodone.
❑ The most widely used class of antidepressant drugs, TCAs prevent the reuptake of norepinephrine or serotonin (or both) into the presynaptic nerve endings, resulting in increased synaptic concentrations of these neurotransmitters. They also cause a gradual loss in the number of beta-adrenergic receptors.
❑ After resolution of the acute episode, patients with a history of recurrent depression may be maintained on low doses of antidepressants as a preventive measure.
❑ Selective serotonin reuptake inhibitors, including fluoxetine, paroxetine, and sertraline, are increasingly becoming the drugs of choice. They are effective and produce fewer adverse effects than the TCAs; however, they’re associated with sleep and GI problems and alterations in sexual desire and function.
❑ MAO inhibitors block the enzymatic degradation of norepinephrine and serotonin. These agents are commonly prescribed for patients with atypical depression (for example, depression marked by an increased appetite and need for sleep, rather than anorexia and insomnia) and for some patients who fail to respond to TCAs.
MAO inhibitors are associated with a high risk of toxicity; patients treated with one of these drugs must be able to comply with the necessary dietary restrictions. Conservative doses of an MAO inhibitor may be combined with a TCA for patients refractory to either drug alone.
Maprotiline is a potent blocker of norepinephrine uptake, whereas trazodone is a selective serotonin uptake blocker. The mechanism of action of bupropion is unknown.
ECT
When a depressed patient is incapacitated, suicidal, or psychotically depressed, or when antidepressants are contraindicated or ineffective, ECT is commonly the treatment of choice. Six to 12 treatments usually are needed, although improvement is usually evident after only a few treatments. Researchers hypothesize that ECT affects the same receptor sites as antidepressants.
Psychotherapy
Short-term psychotherapy is also effective in treating major depression. Many psychiatrists believe that the best results are achieved with a combination of individual, family, or group psychotherapy and medication. Therapeutic interventions focus on identifying the patient’s negative thoughts and interpretations and substituting adaptive responses.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Skin, clammy:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Take the patient’s vital signs frequently and monitor urine output. If clammy skin occurs with an anxiety reaction or pain, offer the patient emotional support, administer pain medication, and provide a quiet environment.
Patient teaching
If an underlying illness is related to the patient’s clammy skin, provide information on the condition. If the condition is related to an alteration in the patient’s blood glucose level, provide information on management of hypoglycemia and early signs of a falling blood glucose level. Provide information on the importance of nutrition and hydration.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Agitation:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Orient the patient with agitation to the unit and its procedures and routines. Provide reassurance and emotional support. Explain the need to reduce stressors and maintain a quiet environment.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Anxiety:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient relaxation techniques and practice them with him. Encourage the patient to verbalize his anxiety and listen to him attentively. Help the patient identify and explore coping mechanisms that he used in the past. Work with the patient to identify stressors and guide him in effective coping skills.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Skin, clammy:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Because the patient with cool, clammy skin may be acutely ill, provide emotional support to him and his family. Explain what’s happening using short, simple sentences. Orient them to the intensive care unit, if applicable, explaining the equipment and the unit’s routines.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Agitation:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Because agitation can be an early sign of many different disorders, monitor the patient's vital signs and neurologic status while the cause is being determined.
▪ Eliminate stressors, which can increase agitation.
▪ Provide adequate lighting, maintain a calm environment, and allow the patient ample time to sleep.
▪ Ensure a balanced diet, and provide vitamin supplements and hydration.
▪ Remain calm, nonjudgmental, and nonargumentative.
▪ Avoid using restraints, unless absolutely necessary, because they tend to increase agitation.
▪ If appropriate, prepare the patient for diagnostic tests, such as a computed tomography scan, skull X-rays, magnetic resonance imaging, and blood studies.
Patient teaching
▪ Orient the patient to the unit and its procedures and routines.
▪ Explain stress-reduction measures.
▪ Offer reassurance and emotional support.
▪ Explain all tests and procedures, the underlying cause, and treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Anxiety:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Provide supportive care, as indicated by the patient's signs and symptoms.
▪ Provide a calm, quiet atmosphere.
▪ Administer medications, as ordered, to reduce anxiety.
▪ Treat the underlying cause of the patient's anxiety, if known.
▪ Encourage the patient to express his feelings and concerns.
Patient teaching
▪ Teach the patient anxiety-reducing measures, such as distraction, relaxation techniques, or biofeedback.
▪ Teach the patient coping mechanisms to help control his anxiety.
▪ Explain the underlying causes of his anxiety, if known.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Skin, clammy:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Take the patient's vital signs frequently.
▪ Monitor the patient's intake and output.
▪ Provide measures to correct the underlying condition. For example, if clammy skin occurs with an anxiety reaction or pain, offer the patient emotional support, administer pain medication, and provide a quiet environment.
Patient teaching
▪ Explain the underlying disorder and its treatment.
▪ Orient the patient to the intensive care unit.
▪ Explain any diagnostic tests or procedures.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Fontanel depression:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the infant's vital signs and level of consciousness.
▪ Monitor intake and output and watch for signs of worsening dehydration.
▪ Obtain serum electrolyte values to check for an increased or decreased sodium, chloride, or potassium level.
▪ If the infant has mild dehydration, provide small amounts of clear fluids frequently or provide an oral rehydration solution.
▪ If the infant can't ingest sufficient fluid, begin I.V. parenteral nutrition.
▪ If the patient has moderate to severe dehydration, provide rapid restoration of extracellular fluid volume to treat or prevent shock.
▪ Continue to administer I.V. solution with sodium bicarbonate added to combat acidosis. As renal function improves, administer I.V. potassium replacements.
▪ When the infant's fluid status stabilizes, begin to replace depleted fat and protein stores through diet.
▪ Obtain urinalysis for specific gravity and, possibly, blood tests to determine blood urea nitrogen and serum creatinine levels, osmolality, and acid-base status.
Patient teaching
▪ Explain all procedures and treatments to the infant's parents.
▪ Provide emotional support.
▪ Explain ways to prevent dehydration.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Buy Products Related to Treatments for Anxiety Disorders
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
