Anxiety is associated with abnormal function on neurotransmitters that regulate brain activity, mood, and the fear response.
Natural benzodiazepine receptors, along with serotonin and norepinephrine, help regulate neurotransmitters.
There are two main types of anxiety: panic disorder and generalized anxiety disorder; other types include phobic disorders and OCD.
Panic disorder is characterized by chest pain, difficulty breathing, palpitations, dizziness, sweating, a choking sensation, trembling, and unrealistic feelings of doom.
Symptoms and feelings can occur in the absence of typical stimuli; onset is sudden and quick, an “attack.”
Formal diagnosis is made when a patient experiences at least three panic attacks in three weeks.
Generalized anxiety disorder is characterized by excessive worry that causes significant distress or disturbance to work or social functioning and continues for at least six months. Symptoms include restlessness, irritability, difficulty concentrating, muscle tension, sleep disturbances, and fatigue. Symptoms are constant and do not subside, and can become debilitating and interfere with normal life activities.
Post-traumatic stress disorder (PTSD) is a type of anxiety; prevalent in military personnel returning from combat. PTSD occurs in response to a traumatic event. Symptoms include re-experiencing the trauma, and avoidance behavior.
Hypnotic a medication that causes sedation and relaxation.
Sedative another word for hypnotics, used to induce sleep.
Benzodiazepines, may be useful for short term treatment for panic disorders, as well as generalized anxiety disorder.
SSRIs can be used for PTSD and anxiety.
Benzodiazepines are the drugs of choice for generalized anxiety disorder; also used for panic disorder and PTSD; used as pre-anesthetic medications to calm patients prior to procedures; standard treatment for alcohol withdrawal symptoms and status epilepticus.
Benzodiazepines work by stimulating omega receptors in the CNS, causing drowsiness and relaxation.
For anxiety, they have a calming and sometimes euphoric effect.
For sleep, they reduce the time it takes to fall asleep, decrease early morning wakening, and generally improve sleep quality.
Side effects include constipation, muscle weakness, and impaired reflexes; patients can also experience difficulty waking in the morning and leftover drowsiness.
Other effects for concern include over sedation and respiratory depression; increased heart rate.
Patients should not drink alcohol or take other medications that may cause sedation.
All benzodiazepines are controlled substances and carry some risk of dependence and abuse potential.
Buspirone (Buspar) is a preferred antianxiety medication because it is not a controlled substance and does not cause euphoria like benzodiazepines. Buspirone works by blocking serotonin receptors in the brain; must be taken on a regular basis to be effective.
Side effects include drowsiness, dizziness, headache, and nausea; serious side effects include hostility, depression, serotonin syndrome, and extrapyramidal symptoms.
It is also associated with depression and increased suicidal tendencies and should not be taken with MAOIs
.Insomnia – the inability to fall asleep or stay asleep; often a symptom of depression, anxiety, and other mental disorders.
Usually insomnia is a reaction to a stressful situation and simply a disruption of the normal sleep cycle.
Some medical conditions can affect the ability to sleep.
Disorders that can affect sleep include obstructive sleep apnea, restless leg syndrome, and narcolepsy.
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