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Generalized Anxiety Disorder

Introduction

Generalized anxiety disorder (GAD) is an ongoing anxiousness that is difficult to control. The primary symptoms of GAD include intense worry about several activities or events that lasts for at least six months, disruptions in social and professional functioning, difficulty managing anxiety, and anxiety that is much more intense than what would be expected from dangerous situations (Flückiger, Christoph, et al. 2022). GAD can affect both children and adults and dealing with it can be difficult over time. Therefore, the right medication must be taken.

Pharmacokinetics and Pharmacodynamics Related to Anxiolytic Medications for GAD

An effective pharmaceutical strategy that integrates pharmacokinetic and pharmacodynamic optimization will guarantee improved therapy and individualized care for anxiety disorders. Pharmacokinetics involves how the body absorbs, distributes, metabolizes, and excretes drugs. An example is Ketamine, a medication for GAD. It reduces a patient’s dissocial rates (Glue et al., 2020). These are symptoms of disconnection between memories, feelings, thoughts, and even actions. Ketamine metabolizes in the body, and its extraction is in the urine. Sonmez et al. (2020) notes that almost 88% of Riluzole medication metabolizes either through oxidation or glucuronidation. The metabolic abilities make it partially like Ketamine.

 Pharmacodynamics entails how drugs affect the body. For instance, Agomelatine medication for GAD stimulates the body through MT1 and MT2 (receptor agonist) and 5-HT2c (receptor antagonist) (Sonmez et al., 2020). Unlike Riluzole, with a 12-hour half-life, Agomelatine takes only 2.3 hours.

According to Mayo Clinic (2017), generalized anxiety disorder is managed with a variety of drugs, some of which are listed below. The advantages, hazards, and potential side effects should all be discussed with your doctor. As a first line of treatment, antidepressants, notably those in the SSRI and SNRI classes (serotonin and norepinephrine reuptake inhibitors), are used. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR), and paroxetine (Paxil, Pexeva). Various additional antidepressants might be suggested by your doctor. The usage of buspirone, an anti-anxiety drug, is possible continuously. It may take many weeks for it to start working effectively, like with most antidepressants. Your doctor may, under some conditions, recommend a benzodiazepine to treat the symptoms of anxiety. 

Factors which Interfere with Pharmacokinetic and Pharmacodynamic Processes

Serum BDNF is responsible for the survival and maintenance of synaptic and neurons. However, a decrease in Serum BDNF causes depression, thus affecting pharmacokinetics medication (Glue et al., 2020). Age, previous treatment, and co-morbidity can hinder the pharmacodynamics of medication for this illness. For older patients, 65 years, drugs like Citalopram are likely to be ineffective due to their slow metabolism (Strawn et al., 2018). Pharmacokinetics factors like age, gender, and use of drugs also affect pharmacodynamics treatment for GAD. Chemical imbalances and dysbalanced processes also affect medications (Sartori & Singewald, 2019). Some examples are Endogenous (genetic) and exogenous (environmental and epigenetic), which can be problematic.

In summary based on these factors that could affect pharmacokinetic and pharmacodynamics medications for Treating GAD, personalization of care is necessary. It will entail adopting a routine activity like physical exercises, given that anxiety comes from traumatic experiences. Secondly, helping a client prioritize issues can help by carefully managing energy and time.

References

Flückiger, C., Carratta, K., Del Re, A. C., Probst, G., Vîslă, A., Gómez Penedo, J. M., & Wampold, B. E. (2022). The relative efficacy of bona fide cognitive behavioral therapy and applied relaxation for generalized anxiety disorder at follow-up: A longitudinal multilevel meta-analysis. Journal of Consulting and Clinical Psychology, 90(4), 339–352. https://doi.org/10.1037/ccp0000717.supp (Supplemental)

Generalized anxiety disorder – Diagnosis and treatment – Mayo Clinic. (2017, October 13). Generalized Anxiety Disorder – Diagnosis and Treatment – Mayo Clinic. Retrieved October 19, 2022, from https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/diagnosis-treatment/drc-20361045#:~:text=The%20two%20main%20treatments%20for,treatments%20work%20best%20for%20you.

Glue, P., Neehoff, S., Sabadel, A., Broughton, L., Le Nedelec, M., Shadli, S., McNaughton, N., & Medlicott, N. J. (2020). Effects of Ketamine in patients with treatment-refractory generalized anxiety and social anxiety disorders: exploratory double-blind psychoactive-controlled replication study. Journal of Psychopharmacology, 34(3), 267-272. https://doi.org/10.1177/0269881119874457

Sartori, S. B., & Singewald, N. (2019). Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders. Pharmacology & Therapeutics, 204, 107402. https://doi.org/10.1016/j.pharmthera.2019.107402

Sonmez, A. I., Almorsy, A., Ramsey, L. B., Strawn, J. R., & Croarkin, P. E. (2020). Novel pharmacological treatments for generalized anxiety disorder: Pediatric considerations. Depression and Anxiety, 37(8), 747–759. https://doi.org/10.1002/da.23038

Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert Opinion on Pharmacotherapy, 19(10), 1057-1070. https://doi.org/10.1080/14656566.2018.1491966.