Anxiety

Anxiety is an [blank_start]emotional[blank_end] state, ranging from [blank_start]mild[blank_end] stress to feeling of impending doom.

Name two psychological symptoms of anxiety. 1. [blank_start]insomnia[blank_end] 2. [blank_start]poor concentration[blank_end]

Anxiety causes somatic side effects such as enhanced [blank_start]sympathetic[blank_end] activty

Anxiety is affected by disturbances of the [blank_start]arousal[blank_end] systems in the CNS

The major neurotransmitters responsible in the [blank_start]limbic[blank_end] region of the brain are [blank_start]5-HT[blank_end], [blank_start]noradrenaline[blank_end], and disturbances of [blank_start]GABA[blank_end].

The [blank_start]Amygdala[blank_end] section of the brain is responsible for anxiety and fear.

Name two main classes of anxiolytics used. 1. [blank_start]benzodiazepines[blank_end] 2. [blank_start]buspirone[blank_end]

Benzodiazepines work by binding the [blank_start]BZD[blank_end] site of the [blank_start]GABAa[blank_end] receptor and facilitate [blank_start]GABA[blank_end] binding. [blank_start]GABA[blank_end] opens Cl- channel and [blank_start]hyperpolarises[blank_end] the membrane.

Name four benzodiazepines. 1. c[blank_start]lonazepam[blank_end] 2. d[blank_start]iazepam[blank_end] 3. o[blank_start]xazepam[blank_end] 4. l[blank_start]orazepam[blank_end]

Barbiturates work by enhancing the effect of [blank_start]GABA[blank_end] on [blank_start]GABAa[blank_end] receptors by binding to the [blank_start]B[blank_end]-subunit. They also block [blank_start]AMPA[blank_end] receptors. The neurotransmitter [blank_start]glutamate[blank_end] binds to the AMPA receptor.

Buspirone is a [blank_start]5-HT1A[blank_end] receptor partial [blank_start]agonist[blank_end]. These are receptors on the [blank_start]pre[blank_end]-synaptic membrane and act as a [blank_start]negative[blank_end] feedback mechanism. By agonising this receptor it [blank_start]stops[blank_end] the production of [blank_start]5-HT[blank_end].

SSRIs are first-line for generalised anxiety disorder.

Sertraline is used first-line for anxiety disorders.