Posted: December 20th, 2021

Discussion: Decision Making When Treating Psychological Disorders

Week 8 Discussion; Generalized Anxiety Disorder

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The patient is a 46-year-old white male who presents to the clinic, stating that he feels like he has a heart attack. He complained of shortness of breath, chest tightness, and a feeling of doom. EKG was done, and the results were normal. The patient later termed the feeling anxiety attack. He drinks 3-4 beers/night. The patient was diagnosed with a generalized anxiety disorder (GAD). The patient is experiencing a panic attack. The feeling of heart attack and rushing to the ER is a panic attack. All four classes of antidepressants can be used in the treatment of panic attacks (Rosenthal & Burchum, 2018). The selective serotonin reuptake inhibitor (SSRI) is the first line of treatment for panic attack (Rosenthal & Burchum, 2018).

The patient treatment will begin with Zoloft 50mg orally daily. This is one of the medications for the first line of treatment for generalized anxiety disorder. The patient consumes alcohol, and so it will not be advisable to start him with a drug that he will be addictive too. The patient returned, stating that there is some relief. He does not feel the chest tightness and shortness of breath, and the worry at work has decreased. The provider will recommend the patient to continue the current dose until next visit. The treatment with SSRIs takes about 6-12weeks to realize full effectiveness ((Rosenthal & Burchum, 2018). Treatment guidelines for panic attacks favor SSRIs over benzodiazepines (BZs) based on the belief that BZs are associated with more adverse effects than SSRIs (Quagliato et al., 2019).

Upon return to the clinic, the patient reports no further decrease of anxiety and wonders if medication is effective; the provider can now increase to 75mg PO daily.

Anxiety disorders can be treated, and so patients should be informed of the therapeutic options and should be involved in treatment planning (Ströhle, Gensichen, & Domschke, 2018).

References:

Quagliato, L. A., Cosci, F., Shader, R. I., Silberman, E. K., Starcevic, V., Balon, R., … Nardi,

A. E. (2019). Selective serotonin reuptake inhibitors and benzodiazepines in panic

disorder: A meta-analysis of common side effects in acute treatment.

Journal of Psychopharmacology, 33(11), 1340–1351.

https://doi-org.ezp.waldenulibrary.org/10.1177/0269881119859372

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced

practice providers. St. Louis, MO: Elsevier.

Ströhle, A., Gensichen, J., & Domschke, K. (2018). The diagnosis and treatment of

anxiety disorders. Deutsches Aerzteblatt International, 115(37), 611–620.

https://doi-org.ezp.waldenulibrary.org/10.3238/arztebl.2018.0611

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