Anxiety disorders case study

Other Antidepressants. Antidepressant refinements for the next 30 years primarily consisted of the development of new TCAs. However, in 1988, a novel antidepressant class, the selective serotonin reuptake inhibitors (SSRIs), was introduced in the United States. The chief innovation of the SSRIs was that they afforded the comparable effectiveness of the TCAs with fewer side effects and minimal toxicity. The debut of the SSRIs coincided with the reworking of the nosology of the anxiety disorders in DSM-III and DSM-IV. As a result, the SSRIs have been studied extensively in each of the respective anxiety disorders and in many cases have obtained FDA approval for the treatment of one or more of these anxiety syndromes. The SSRIs currently available in the United States include citalopram (Celexa), escitalo-pram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). 

The extent of Buspirone experience in children and adolescents is limited to open studies and case reports. There are no published double-blind placebo-controlled studies of Buspirone for pediatric anxiety disorders or any other psychiatric disorder. Results of a recently completed large (n = 350 ages 6-17 years), industry-sponsored, multisite study of Buspirone for children (15-30 mg/day) and adolescents (45-60 mg/ day) with GAD have not been published or presented at open academic conferences. Until such data are made available, the use of Buspirone for treatment of pediatric anxiety disorders remains speculative. 

Despite the history of robust BZ anxiolytic impact in adults, controlled studies, open studies, and case reports of BZs for pediatric anxiety have not been impressive. Concerns about BZ-related adverse events, such as behavioral disihnhibition, have since slowed interest in controlled studies of BZs for treatment of pediatric anxiety disorders. Three small placebo-controlled studies of BZs for pediatric anxiety disorders have been published and none demonstrated... 

Because OCD is considered one of the anxiety disorders according to DSM-IV [American Psychiatric Association 1994] [but not according to ICD-10 [World Health Organization 1992]], it is not surprising that anxiolytics have been suggested for its treatment. Thus, alprazolam and clonazepam have been reported as efficient in several uncontrolled studies and case series [Hewlett et al. 1990 Tollefson 1985]. 

B. Gaster and J. Holroyd, St. John s Wort for Depression A Systematic Review. Archives of Internal Medicine 160 (January 24, 2000) 152-156 E. Shrader, Equivalence of St. John s Wort Extract and Fluoxe tine A Randomized, Controlled Study in Mild Moderate Depression. Inter-national Clinical Psychopharmacology 15, no. 2 (2000) 61-68 L. Taylor and K. A. Kobak, An Open-Label Trial of St. John s Wort in Obsessive Compulsive Disorder. Journal of Clinical Psychiatry 61 (August 2000) 575-578 J. R. T. Davidson and K. M. Connor, St. John s Wort in Generalized Anxiety Disorder Three Case Reports. Journal of Clinical Psychopharmacology 21... 

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