Business Description
Treatment strategy: The purpose of the technique for anxiety attacks is always to raise the success rate of clinical treatment, promote the disappearance of clinical signs and signs and symptoms, and restore social function. By strengthening the extended-term follow-up, the recurrence minute rates are reduced as well as the prognosis has been enhanced.medical treatment
1. Benzodiazepines
It's a fast onset and effective anti-anxiety effect. Short-term use may very well be for patients with acute anxiety. The general treatment time does not exceed 2 to 3 days.
2.5-HTIA receptor partial agonist
The mechanism of action is always to bind to 5-HTIA receptors and partially activate the postsynaptic to reduce 5-HT neurotransmission and play an anti-anxiety effect the partial activation of presynaptic 5-HT body receptors promotes 5-HT Release within the presynapse, exert an antidepressant effect.
Right now, buspirone and tandospirone are usually used clinically. The advantages are light sedation, less dyskinesia, no respiratory system depression, and little impact on cognitive function nevertheless the onset is pretty slow, about 2 to 4 days, and the individual needs six or seven days. Continuous treatment can raise effectiveness. Along with monoamine oxide inhibitors is illegitimate.
3. Tricyclic drugs (TCAs)
TCAs are common antidepressants, including imipramine, amitriptyline, clomipramine, doxepin, and tetracyclic maprotiline. The main medicinal action is always to hinder the uptake of norepinephrine and 5-HT by presynaptic neurons while growing the power of the neurotransmitters inside the synaptic cleft.
Therefore, the general dosage for anti-anxiety and anti-depressant effects is 50-250 mg/d, as well as the dosage, is progressively elevated and introduced in divided doses. Along with monoamine oxidase inhibitors is illegitimate.
4. Selective serotonin reuptake inhibitors (SS-RIs)
It might hinder the 5-HT reuptake of presynaptic 5-HTergic nerve endings, mainly including fluoxetine, paroxetine, sertraline, clovoxamine, citalopram, and escitalopram. Paroxetine is considered the most broadly used drugs for anxiety attacks.
SSRIs is able to reduce anxiety or depression based on anxiety, particularly for that seniors.
Typically the most popular top features of SSRIs are ①Broad-spectrum: effective for several depression states ②Efficacy: the ***** of every drug is equivalent, as well as the effective minute rates are 60%~70% ③Slow onset: the onset time is 2~three days ④ Compliance: daily, good compliance, which supports to boost the success rate of treatment ⑤ Safety: less negative effects, good tolerance, and safety. It's forbidden for people allergic to SSRIs it's coupled with caution for patients with severe heart, liver, and kidney illnesses it's forbidden for doing things along with monoamine oxidase inhibitors and tryptophan.
5. Serotonin and norepinephrine reuptake inhibitor (SNRI)
Representative prescription medication is venlafaxine and duloxetine. Venlafaxine sustained-release agent has a significant curative effect, stable extended-term therapeutic effect, and good tolerance. Patients with severe kidney and liver disease, hypertension, and epilepsy need to be coupled with caution with high-degree narrow-position glaucoma. SNRIs should not be in conjunction with monoamine oxidase inhibitors as well as other 5-HT agonists to avoid serotonin syndrome.
6. Other drugs
(1) The representative drug of NE and particular 5-HT antidepressants (NaSSAs) is mirtazapine. It's appropriate for every type of depressive episode, especially patients with severe depression and apparent anxiety, agitation, and insomnia. Common negative effects are sedation, sleepiness, dizziness, fatigue, appetite, and extra weight.
(2) Serotonin receptor antagonism and reuptake inhibitor (SARI) has serotonin (5-HT) receptor antagonism and reuptake inhibitory effects, that could treat various anxiety attacks. Trazodone.
(3) Other drugs: Propranolol could be the representative drug of β receptor blocker. It's mainly familiar with relieve various physical signs and signs and symptoms of hysteria disorder, for instance, palpitations, tremors, tachycardia, etc. It's a limited effect on treating generalized anxiety attacks alone.
Attention
(1) Carefully observe modifications in the issue and negative effects during treatment. Inform the person in regards to the drug's effects, treatment, possible negative effects, and countermeasures
(2) During extended-term medication, the curative effect needs to be regularly evaluated, if you should continue medication bloodstream routine, kidney and liver function needs to be monitored
(3) In the event you receive medication during pregnancy or breastfeeding, you need to weigh the hazards of exposure in the fetus and infant to medications and also the hazards of moms not applying medications
(4) Take serious notice of the dependence of benzodiazepine drugs (for instance rebound insomnia, memory impairment, and withdrawal syndrome), especially the seniors due to impaired physical function and fall easily, this type of lengthy time-term use needs to be avoided. As opposed to extended half-existence drugs, short to medium half-existence prescription medication is more susceptible to the above pointed out problems
(5) Single medication needs to be used whenever you can, with lots of amounts and full treatment generally, it isn't recommended to utilize more than two anti-anxiety drugs if needed, two anti-anxiety drugs with assorted mechanisms of action can be utilized together
(6) Atypical antipsychotics are recommended for second-line or third-line control over anxiety attacks, preferably along with first-line antidepressants concurrently, the advantages and disadvantages of effectiveness and negative effects are thought.
