response on discussion post 200 words + 2 sourses
Read a selection of your colleagues and respond to your colleagues by suggesting additional factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients diagnosed with GAD. In addition, suggest different treatment options you would suggest to treat a patient with the topic of discussion.
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Medications used in Treating Generalized Anxiety Disorder (GAD)
Selective serotonin reuptake inhibitors (SSRIs) such as escitalopram, duloxetine, venlafaxine, and paroxetine are commonly used to treat generalized anxiety disorder (GAD). These pharmacological agents are recommended as the first-line treatment for GAD due to their effectiveness in reducing excessive worry and fear in GAD patients (Strawn et al., 2018). SSRIs manage GAD symptoms by increasing the level of serotonin in the brain (Kendrick, 2021). Additionally, SSRIs enhance the processing of serotonin in the brain, reducing the severity of GAD symptoms. SSRIs have a lower risk of side effects than other drugs treating GAD. Common side effects reported in various SSRIs used in treating GAD include increased anxiety at the beginning of treatment, diarrhea, nausea, headaches, dry mouth, and sexual side effects such as erectile dysfunction (Kendrick, 2021). SSRIs are eliminated from the body through hepatic biotransformation, which involves the cytochrome P450 iso-enzymes.
Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as are venlafaxine and duloxetine also recommended as the first-line treatment of GAD. SNRIs are the FDA-approved treatment for GAD due to their efficacy in reducing fear and excessive worry (Garcia & O’Neil, 2021). SNRIs stabilize neurotransmitters in the brain, reducing the feeling of anxiety. Although most patients highly tolerate SNRIs, they are associated with various drug-related adverse effects, including nausea, dry mouth, tiredness, constipation, and sweating (Garcia & O’Neil, 2021). The liver metabolizes SNRIs through the cytochrome P450 CYP2D6 enzyme.
Atypical antipsychotics are also used in treating GAD symptoms. The FDA has approved atypical antipsychotics such as olanzapine, aripiprazole, and quetiapine for treating mental health conditions, including schizophrenia and bipolar disorders. However, atypical antipsychotics enhance the management of GAD when combined with anti-anxiety medications such as SSRIs or SNRIs (Forth et al., 2023). Specifically, atypical antipsychotics treat GAD in individuals who fail to respond to first-line treatments alone (Forth et al., 2023). Atypical antipsychotics reduce anxiety by blocking dopamine receptors found in the brain. Unlike SSRIs and SNRIs, atypical antipsychotics expose GAD patients to severe side effects, including metabolic changes such as high cholesterol, weight gain, and movement problems. The liver extensively metabolizes atypical antipsychotics, producing toxic-free radical metabolic intermediates that might cause liver damage.