NSG 552 Psychopharmacology Exam 2 Study Guide (Week 5)
The first-line treatment for anxiety disorders generally includes selective serotonin reuptake
inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs), as they are
effective for long-term management and have a favorable side effect profile.
Cognitivebehavioral therapy (CBT) is also recommended as a first-line non-pharmacological
treatment.
Common SSRIs for Anxiety Disorders:
1. Sertraline (Zoloft)
2. Escitalopram (Lexapro)
3. Paroxetine (Paxil)
4. Fluoxetine (Prozac)
Common SNRIs for Anxiety Disorders:
1. Venlafaxine (Effexor XR)
2. Duloxetine (Cymbalta)
These medications help by regulating serotonin and norepinephrine levels, which can reduce
anxiety symptoms over time. Depending on the severity of the disorder and patient preference,
benzodiazepines may be used short-term to manage acute symptoms, though they are not
recommended for long-term use due to their risk of dependence.
Cognitive Behavioral Therapy (CBT):
CBT is highly effective for treating anxiety by helping patients challenge and change unhelpful
thoughts and behaviors. CBT is often recommended in conjunction with medication or as a
standalone treatment.
In summary, SSRIs, SNRIs, and CBT are first-line treatments for anxiety disorders, with
medication providing symptom relief and CBT addressing the underlying thought patterns and
behaviors.
Tricyclic antidepressants (TCAs) have the highest anticholinergic effects when compared to
selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines. Here’s a breakdown:
, 1. Tricyclic Antidepressants (TCAs):
• High anticholinergic effects: TCAs, such as amitriptyline and imipramine, block
acetylcholine receptors, leading to significant anticholinergic side effects. These effects
include dry mouth, constipation, urinary retention, blurred vision, and confusion,
particularly in older adults.
2. Selective Serotonin Reuptake Inhibitors (SSRIs):
• Low anticholinergic effects: SSRIs, like sertraline and fluoxetine, have minimal
anticholinergic activity compared to TCAs. As a result, they are often preferred for
patients who are sensitive to these side effects. However, some SSRIs may still cause
mild effects such as dry mouth.
3. Benzodiazepines:
• Minimal to no anticholinergic effects: Benzodiazepines, like diazepam and lorazepam,
are primarily used for their anxiolytic effects and have negligible anticholinergic
properties. They do not commonly cause the typical anticholinergic side effects seen
with TCAs.
Summary:
• TCAs have the highest anticholinergic effects.
• SSRIs have lower anticholinergic effects.
• Benzodiazepines have little to no anticholinergic effects.
Because of the high anticholinergic burden, TCAs are generally used with caution, especially in
older adults or patients with conditions exacerbated by these side effects (e.g., glaucoma,
urinary retention).
Activating antidepressants, particularly those with stimulating properties, can sometimes lead
to symptoms of anxiety, agitation, and restlessness. The most commonly associated
antidepressants include:
1. Fluoxetine (Prozac) – An SSRI known for its stimulating effects, it can cause increased
restlessness or anxiety, especially at the beginning of treatment.
The first-line treatment for anxiety disorders generally includes selective serotonin reuptake
inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs), as they are
effective for long-term management and have a favorable side effect profile.
Cognitivebehavioral therapy (CBT) is also recommended as a first-line non-pharmacological
treatment.
Common SSRIs for Anxiety Disorders:
1. Sertraline (Zoloft)
2. Escitalopram (Lexapro)
3. Paroxetine (Paxil)
4. Fluoxetine (Prozac)
Common SNRIs for Anxiety Disorders:
1. Venlafaxine (Effexor XR)
2. Duloxetine (Cymbalta)
These medications help by regulating serotonin and norepinephrine levels, which can reduce
anxiety symptoms over time. Depending on the severity of the disorder and patient preference,
benzodiazepines may be used short-term to manage acute symptoms, though they are not
recommended for long-term use due to their risk of dependence.
Cognitive Behavioral Therapy (CBT):
CBT is highly effective for treating anxiety by helping patients challenge and change unhelpful
thoughts and behaviors. CBT is often recommended in conjunction with medication or as a
standalone treatment.
In summary, SSRIs, SNRIs, and CBT are first-line treatments for anxiety disorders, with
medication providing symptom relief and CBT addressing the underlying thought patterns and
behaviors.
Tricyclic antidepressants (TCAs) have the highest anticholinergic effects when compared to
selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines. Here’s a breakdown:
, 1. Tricyclic Antidepressants (TCAs):
• High anticholinergic effects: TCAs, such as amitriptyline and imipramine, block
acetylcholine receptors, leading to significant anticholinergic side effects. These effects
include dry mouth, constipation, urinary retention, blurred vision, and confusion,
particularly in older adults.
2. Selective Serotonin Reuptake Inhibitors (SSRIs):
• Low anticholinergic effects: SSRIs, like sertraline and fluoxetine, have minimal
anticholinergic activity compared to TCAs. As a result, they are often preferred for
patients who are sensitive to these side effects. However, some SSRIs may still cause
mild effects such as dry mouth.
3. Benzodiazepines:
• Minimal to no anticholinergic effects: Benzodiazepines, like diazepam and lorazepam,
are primarily used for their anxiolytic effects and have negligible anticholinergic
properties. They do not commonly cause the typical anticholinergic side effects seen
with TCAs.
Summary:
• TCAs have the highest anticholinergic effects.
• SSRIs have lower anticholinergic effects.
• Benzodiazepines have little to no anticholinergic effects.
Because of the high anticholinergic burden, TCAs are generally used with caution, especially in
older adults or patients with conditions exacerbated by these side effects (e.g., glaucoma,
urinary retention).
Activating antidepressants, particularly those with stimulating properties, can sometimes lead
to symptoms of anxiety, agitation, and restlessness. The most commonly associated
antidepressants include:
1. Fluoxetine (Prozac) – An SSRI known for its stimulating effects, it can cause increased
restlessness or anxiety, especially at the beginning of treatment.
