Anxiety disorders Post-traumatic stress disorder

Antidepressants may benefit most forms of anxiety disorder, including panic disorder, generalised anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder and social phobia (see p. 393). 

Obsessive compulsive disorder, panic disorder, generalized anxiety disorder, bulimia nervosa, social anxiety disorders, post-traumatic stress disorder, dementia, dysthymia, premature ejaculation. Citalo-pram (investigational) is used for dementia, smoking cessation, ethanol abuse, OCD in children with diabetic neuropathy. Sertraline and Sarafem (contains fluoxetine) are also used to treat premenstrual dysphoric disorder. 

Anxiety, depression, insomnia, different types of phobia, obsessive-compulsive disorder, post-traumatic stress disorder, panic attacks, acute stress disorder. It is also related to chronic diseases, such as anemia, and diseases of the heart and lung. 

PMDD is not the only mental disorder that can be treated with SSRIs. There are many kinds of syndromes that SSRIs have been approved to treat. These syndromes include eating disorders, obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder, and generalized anxiety disorder. Although each SSRI would probably be just as effective in treating these syndromes, the companies that own them have done extensive research to find a niche for their drug. Thus some SSRIs, such as Paxil (paroxetine), are approved for social phobia simply because the company that owns them has done the clinical studies proving it is effective and therefore should be licensed for it. Indeed, there seems to be no end to syndrome niche markets in which SSRIs can be effective. There are now efforts to market some SSRIs as treatments... 

Anxiety (refusal to go to school, phobias, separation or social fears, generalized anxiety, or post-traumatic stress disorders)—if it keeps the youngster from normal daily activities. 

Bandelow B, Zohar J, Hollander E, et al. Guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders. World J Biol Psychiatry 2002 3 171-199. 

Post-traumatic Stress Disorder (PTSD). Persistent anxiety is an invariable feature of both GAD and PTSD. In the case of GAD, the worry relates to a wide array of situations. As for PTSD, the worry relates to a perceived threat that is often directly, or at least indirectly, reminiscent of the previous trauma. 

Although we are focusing on the primary sleep disorders, sleep disturbance quite often occurs as a symptom of another illness. Depression, anxiety, and substance abuse can impair the quality of sleep, though in the setting of chronic insomnia, other psychiatric disorders account for less than 50% of cases. Nightmares are a frequent complication of post-traumatic stress disorder (PTSD), and pain, endocrine conditions, and a host of medical illnesses can produce sleep problems. Thus, when discussing insomnia or hypersomnia, we are well advised to remember that these can be either a symptom of a psychiatric syndrome, a medical illness, or a sleep disorder. 

The full complement of anxiety syndromes including panic, generalized anxiety, obsessive-compulsiveness, and post-traumatic stress disorder can arise in the after-math of TBI. In fact, anxiety may be the most common neuropsychiatric complication of TBI. Anxiety appears to be most likely to arise when the injury occurs to the right side of the brain. The treatment alternatives for post-TBl anxiety parallel those used when treating anxiety disorders and include serotonin-boosting antidepressants, buspirone (Buspar), and the benzodiazepines (see Table 12.1). 

Katz RJ, Lott MH, Arbus P, et al. Pharmacotherapy of post-traumatic stress disorder with a novel psychotropic. Anxiety 1994 1 169-174. 

Sheikh JI, Woodward SH, Leskin GA (2003) Sleep in post-traumatic stress disorder and panic Convergence and divergence. Depress Anxiety 18 187-197... 

Post traumatic stress disorder (PTSD) is the only psychiatric condition whose definition demands a particular stressor to precede its appearance. Unlike the other anxiety disorders, it is only in the past decade that the biology of PTSD has come under scrutiny. Furthermore, although PTSD can occur following various traumatic events (for example, sexual abuse, accidents and torture), most emphasis has been placed on combat-related disorders. 

In a placebo-controlled study in 18 combat veterans with post-traumatic stress disorder and 11 healthy controls, intravenous yohimbine 0.4 mg/kg significantly increased the amplitude, magnitude, and probability of the acoustic startle reflex (used as a model to investigate the neurochemical basis of anxiety and fear states) in the veterans with post-traumatic stress disorder but not in the controls (689). 

Kaplan, Z., Amir, M., Swartz, M., and Levine, J., 1996, Inositol treatment of post-traumatic stress disorder. Anxiety 2 51-52. 

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