GENERALIZED ANXIETY DISORDER

Psychobiology and Neuroscience: Generalized Anxiety Disorder

Introduction

From the onset, it would be prudent to note that from time to time, most people feel anxious about diverse events or occurrences in life. This is normal. However, it should be noted that when the said anxiety is persistent, exaggerated and/or excessive, then a person could be likely suffering from Generalized Anxiety Disorder (GAD). In the past, various interventions have been formulated in an attempt to treat this particular condition. The main treatment approaches on this front happen to be medications and psychotherapy. This text concerns itself with the medications approved in the treatment of GAD. In so doing, the main focus will in this case be neurobiology and drug mechanisms of action.

Discussion

In essence, there are various medications that have proven effective and have thus been approved for the treatment of GAD. These medications are especially instrumental in efforts to ease symptoms of the condition. The medications that will be taken into consideration in the subsequent sections of this text are:

a) Antidepressants

b) Benzodiazepines

Antidepressants

These, as Gerlach and Gloster (2020) point out, are essentially considered first-line medications in the treatment of GAD. This is to say that they are routinely used as the first choice of medications for patients diagnosed with GAD. Unlike benzodiazepines, which are usually used in the short-term treatment of the condition, antidepressants come in handy in the longer-term treatment of GAD. In this case, there would be need to take into consideration the mechanism of action of antidepressants in the selective serotonin reuptake inhibitor (SSRI) as well as the selective serotonin-norepinephrine reuptake inhibitor (SNRI) class.

i. Selective Serotonin Reuptake Inhibitors

To begin with, when it comes to SSRIs Gerlach and Gloster (2020) are categorical that as the name suggests, SSRIs exert action by inhibiting the reuptake of serotonin, thereby increasing serotonin activity (213). It therefore follows that SSRIs therapeutic effect is largely founded upon their ability to bring about an increase in deficient serotonin. However, as Strawn, Geracioti, Tajdev, Clemenza, and Levine (2019) indicate, in some instances, SSRIs faintly inhibit the reuptake mechanisms for dopamine and norepinephrine. Essentially, as a neurotransmitter, serotonin happens to be instrumental in the relay or transmission of messages between neurons. Thus, more serotonin (specifically at the postsynaptic membrane in the synapse) effectively means better transmission of the said messages. Examples of SSRIs are fluoxetine, sertraline, paroxetine, as well as citalopram. These will be briefly taken into consideration below.

With regard to fluoxetine, Strawn, Geracioti, Tajdev, Clemenza, and Levine (2019) are categorical that this happens to be one of the SSRIs that were first introduced in the country in the 1970s. According to the authors, the therapeutic effect of this particular SSRI is largely rooted in its ability to bring about an increase in serotonergic transmission. However, the authors also indicate that the drug has been shown to have dopaminergic as well as noradrenergic effects. According to Gerlach and Gloster (2020), the drug is well tolerated among both pediatric and adult patients diagnosed with GAD.

Next, sertraline has also proven to be effective in the treatment of GAD. For instance, in a study seeking to evaluate the effectiveness of this particular drug among pediatric patients presenting with symptoms consistent with GAD, it was found that in comparison to a placebo,...

…between benzodiazepines and the antidepressant medications highlighted elsewhere in this text is that the emergence of the therapeutic effects of the former happens to be soon after administration.

It is important to note that according to Strawn, Geracioti, Tajdev, Clemenza, and Levine (2019), the FDA has only formally approved a single drug in this category for the treatment of generalized anxiety disorder. Thus, according to the authors, is because despite these medications having been exposed to research in patients presenting with symptoms consistent with generalized anxiety disorder, many of these compounds were introduced and evaluated as treatments for anxiety disorders rather than for GAD specifically (Geracioti, Tajdev, Clemenza, and Levine, 2019, p. 1060). It therefore follows that the only formally approved medication on this front happens to be alprazolam. Essentially, this particular drug, as Durbano (2013) points out, modulates the functioning of the GABAA benzodiazepine receptor site following its binding unto the same. However, it should be noted that as Geracioti, Tajdev, Clemenza, and Levine (2019) indicate, in addition to alprazolam, some of the other medications that are routinely used in the treatment of generalized anxiety disorder among adults, despite not having the FDA stamp of approval, are diazepam, lorazepam, and clonazepam.

Conclusion

In the final analysis, it should be noted that in addition to the medications highlighted above, other effective treatment approaches that have been deployed in the past are inclusive of, but they are not limited to psychotherapy with the most common psychotherapy form being utilized on this front being cognitive behavioral therapy. In practice scenarios, a combination of the two approaches, i.e. medications as described above and psychotherapy, may be of…