What medication class is considered first-line pharmacologic treatment for most anxiety disorders?
Selective Serotonin Reuptake Inhibitors (SSRIs).
How long do SSRIs typically take to reach full therapeutic effect?
About 4 weeks, although some clients require longer.
Which anxiety disorders are commonly treated with SSRIs?
Generalized anxiety disorder, panic disorder, social anxiety disorder, OCD, and PTSD.
What are common early adverse effects of SSRIs?
Nausea, headache, fatigue, tremor, diaphoresis, drowsiness, and insomnia.
What are common long-term adverse effects of SSRIs?
Sexual dysfunction and weight gain.
What life-threatening complication is associated with SSRIs?
Serotonin syndrome.
What are manifestations of serotonin syndrome?
Agitation, confusion, fever, diaphoresis, hyperreflexia, tremor, tachycardia, diarrhea, and seizures.
How should SSRIs be discontinued?
Gradually taper the dose to prevent withdrawal symptoms.
Which medications should not be combined with SSRIs?
MAOIs, St. John's wort, and other serotonergic medications.
What medication class provides rapid relief of acute anxiety?
Benzodiazepines.
How do benzodiazepines work?
They enhance the effects of GABA, producing CNS depression.
What are common uses of benzodiazepines?
Short-term treatment of severe anxiety and panic attacks.
What are common adverse effects of benzodiazepines?
Sedation, dizziness, ataxia, impaired judgment, and decreased cognitive function.
Why are benzodiazepines generally prescribed only for short-term use?
They carry a high risk of tolerance, dependence, and withdrawal.
What antidote reverses benzodiazepine toxicity?
Flumazenil.
What teaching should clients receive while taking benzodiazepines?
Avoid alcohol, avoid driving until effects are known, and do not stop the medication abruptly.
What is buspirone primarily used to treat?
Generalized Anxiety Disorder (GAD).
What advantage does buspirone have over benzodiazepines?
It has minimal risk of dependence and does not cause significant sedation.
Can buspirone be used as needed for panic attacks?
No. It must be taken on a scheduled basis.
How long does buspirone take to become fully effective?
Up to 4 weeks.
What foods or supplements should be avoided with buspirone?
Grapefruit juice and St. John's wort.
What is the overall nursing goal of medication therapy for anxiety disorders?
Reduce anxiety, improve daily functioning, and enhance quality of life while minimizing adverse effects.