Anxiolytics and Hypnotics: Anxiety Disorders and Therapeutics
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Questions and Answers

What is the primary neurotransmitter involved in the normal fear response to threatening stimuli?

  • NA (correct)
  • 5-HT
  • GABA
  • Cortisol
  • Which brain region is responsible for planning and predicting, and is affected in Generalised Anxiety Disorder (GAD)?

  • Prefrontal Cortex (correct)
  • Amygdala
  • Hippocampus
  • Cerebellum
  • What is the characteristic feature of Post Traumatic Stress Disorder (PTSD)?

  • Excessive and difficult to control anxiety about several events
  • Somatic symptoms such as sweating and tachycardia
  • Overactive 'fight or flight' response
  • Re-experience of past stressful experiences (correct)
  • Which neurotransmitter is involved in the 'fight or flight' response and is overactive in Panic Disorder?

    <p>NA</p> Signup and view all the answers

    What is the primary brain region involved in fear conditioning and is affected in Post Traumatic Stress Disorder (PTSD)?

    <p>Hippocampus</p> Signup and view all the answers

    What is the lifetime prevalence of Generalised Anxiety Disorder (GAD)?

    <p>4-7%</p> Signup and view all the answers

    What is a characteristic of buspirone's side effect profile compared to benzodiazepines?

    <p>Better side effect profile</p> Signup and view all the answers

    Which neurotransmitter is involved in the noradrenaline (NA) locus coeruleus pathway?

    <p>Noradrenaline</p> Signup and view all the answers

    What is a characteristic of beta-adrenoceptor antagonists, such as propranolol, in treating anxiety disorders?

    <p>Effective in treating physiological symptoms</p> Signup and view all the answers

    What is a characteristic of insomnia, especially chronic insomnia?

    <p>Difficulty falling asleep and staying asleep</p> Signup and view all the answers

    What is the effect of most hypnotics on REM sleep?

    <p>Decrease REM sleep</p> Signup and view all the answers

    What is the characteristic of slow-wave sleep?

    <p>Deepest level of sleep</p> Signup and view all the answers

    What percentage of obsessive compulsive disorder (OCD) cases are classified as severe?

    <p>50%</p> Signup and view all the answers

    Which neurotransmitter is implicated in anxiety, panic disorders, and phobias?

    <p>5-HT</p> Signup and view all the answers

    What is the primary mechanism of action of benzodiazepines in terms of GABA function?

    <p>Increasing chloride channel conductance</p> Signup and view all the answers

    What is the primary indication for combining benzodiazepines with selective serotonin reuptake inhibitors (SSRIs) in anxiety disorders?

    <p>Rapid anxiety relief</p> Signup and view all the answers

    What is the primary risk associated with benzodiazepine overdose when combined with central nervous system (CNS) depressants?

    <p>Respiratory depression</p> Signup and view all the answers

    What is the primary mechanism of action of buspirone in anxiety disorders?

    <p>5-HT1A partial agonism</p> Signup and view all the answers

    The majority of cases of Generalised Anxiety Disorder (GAD) are classified as severe.

    <p>False</p> Signup and view all the answers

    The neurotransmitter 5-HT is implicated in anxiety, panic disorders, and phobias.

    <p>True</p> Signup and view all the answers

    Buspirone is a selective serotonin reuptake inhibitor (SSRI).

    <p>False</p> Signup and view all the answers

    In generalised anxiety disorder, the prefrontal cortex is responsible for basic fear circuit.

    <p>False</p> Signup and view all the answers

    The primary mechanism of action of benzodiazepines is to increase GABA function.

    <p>False</p> Signup and view all the answers

    The neurotransmitter GABA is overactive in panic disorder.

    <p>False</p> Signup and view all the answers

    Benzodiazepines are commonly used as a first-line treatment for anxiety disorders.

    <p>False</p> Signup and view all the answers

    The hippocampus is affected in generalised anxiety disorder (GAD).

    <p>False</p> Signup and view all the answers

    The 'fight or flight' response is primarily mediated by the neurotransmitter GABA.

    <p>False</p> Signup and view all the answers

    The combination of benzodiazepines with central nervous system (CNS) depressants can lead to respiratory depression.

    <p>True</p> Signup and view all the answers

    The lifetime prevalence of post-traumatic stress disorder (PTSD) is 4-7%.

    <p>False</p> Signup and view all the answers

    The amygdala is responsible for planning and predicting in anxiety disorders.

    <p>False</p> Signup and view all the answers

    Buspirone is only effective in treating Generalized Anxiety Disorder (GAD) and has a better side effect profile than benzodiazepines.

    <p>True</p> Signup and view all the answers

    Beta-adrenoceptor antagonists, such as propranolol, are effective in treating the psychological symptoms of anxiety.

    <p>False</p> Signup and view all the answers

    Insomnia can be transient or chronic, depending on the underlying cause.

    <p>True</p> Signup and view all the answers

    Rapid Eye Movement (REM) sleep is characterized by high muscle tone and increased cortisol levels.

    <p>False</p> Signup and view all the answers

    Most hypnotics increase the duration of REM sleep.

    <p>False</p> Signup and view all the answers

    Slow-wave sleep is characterized by an increased metabolic rate and decreased growth hormone levels.

    <p>False</p> Signup and view all the answers

    Study Notes

    Anxiety and Anxiety Disorders

    • Anxiety is a normal fear response to threatening stimuli, characterized by autonomic reflexes, increased arousal and alertness, and defensive behaviors
    • Clinically recognized anxiety disorders include Generalized Anxiety Disorder (GAD), Post-Traumatic Stress Disorder (PTSD), Panic Disorder, Obsessive-Compulsive Disorder (OCD), and Phobias

    Generalized Anxiety Disorder (GAD)

    • Lifetime prevalence: 4-7%, more common in females
    • Characterized by excessive and difficult to control anxiety about several different events or activities
    • Symptoms include worry, irritability, insomnia, and muscle tension
    • GABA dysfunction is implicated in GAD
    • Prefrontal cortex and amygdala are involved in the fear circuit

    Post-Traumatic Stress Disorder (PTSD)

    • Triggered by recall of past stressful experiences
    • Characterized by re-experiencing the trauma, hyper-arousal, and avoidance of stimuli associated with the trauma
    • Decreased hippocampus activity is observed in PTSD

    Panic Disorder

    • Sudden attacks of overwhelming fear with somatic symptoms such as sweating, tachycardia, and hyperventilation
    • Often accompanied by agoraphobia
    • Conditioned fear response is involved in panic disorder

    Obsessive-Compulsive Disorder (OCD)

    • Characterized by obsessions (recurrent and persistent thoughts) and compulsions (repetitive behaviors)
    • Attempt to reduce anxiety by performing rituals
    • Decision-making involves the cortex and basal ganglia
    • Phobias are characterized by excessive and persistent fear of specific objects or situations

    Benzodiazepines (BZD)

    • Target GABA receptors, increasing inhibitory neurotransmission
    • Effective in treating acute anxiety, but have side effects such as drowsiness, confusion, and amnesia
    • Can be addictive and have a high risk of dependence
    • Withdrawal symptoms include increased anxiety, tremors, and insomnia

    Buspirone

    • Effective in treating GAD, with a better side effect profile than BZD
    • Acts as a partial agonist at 5-HT1A receptors
    • Can take several weeks to produce a therapeutic effect
    • Has a lower risk of dependence and withdrawal symptoms compared to BZD

    5-HT Pathways in Anxiety

    • 5-HT is implicated in anxiety, panic disorders, and depression
    • 5-HT cell bodies in raphe nuclei project to areas involved in anxiety, including the hippocampus, amygdala, and prefrontal cortex
    • Decreased 5-HT levels are associated with anxiety disorders
    • SSRI and buspirone target 5-HT pathways to reduce anxiety

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    Description

    This quiz covers the basics of anxiety, clinically recognized anxiety disorders, and the therapeutics used to target chemical mediators involved. It also explores the normal fear response and pathology of anxiety.

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