Anxiety females

MDD is quite common lifetime and 12-month prevalence estimates are 16.2% and 6.6%, respectively. Thus, approximately 35 million United States adults will experience MDD in their lifetime.2 Females are approximately twice as likely as males to experience MDD.2 Although MDD may begin at any age, the average age at onset is the mid-20s.3 Interestingly, MDD appears to occur earlier in life in people born in more recent decades.2 Most patients with MDD also suffer from comorbid psychiatric disorders, especially anxiety disorders and substance-use disorders.2... 

Most studies report higher rates of anxiety disorders among women (2 1 female male) and older adults.5 Data from the... 

A 54-year-old female is treated for essential hypertension with an antihypertensive that controls her blood pressure One day, she comes to the ED with chest pain, tachycardia, anxiety, and a blood pressure of 240/140 mmllg. She has not taken her medication for two days. Which antihypertensive can account for her findings ... 

A 2.%i fear-old female complains of increasing anxiety and restlessness. Physical examination reveals tachycardia and tremors. Palpation of the neck reveals a 3-cm nodule on her thyroid gland. While awaiting laboratory confirmation of the diagnosis, she is given a drug that diminishes her tachycardia and tremors. 

Nicotine reduces anxiety in humans, more so in females than males (Stewart et al. 1997). Similar to nicotine, the nicotinic channel activator ABT-418 has anxiolytic effects (Brioni et al. 1994). Nicotine reduces anxiety and right hemisphere EEG activation in subjects watching a stress-inducing movie (Gilbert et al. 1989). Conversely, smoking cessation is commonly associated with increases in anxiety and dysphoria (West and Hajek 1997). 

The effect of nicotine on anxiety is sexually dimorphic, and specifically in adolescence. Nicotine increased social interaction following social isolation in both male and female rats, indicating an anxiolytic effect. This effect was more... 

For reasons that are not entirely clear, insomnia is also more common in women than men. There are particular times when a woman is especially vulnerable to insomnia, including pregnancy, the transition into menopause, and the premenstrual phase of the menstrual cycle. This, of course, suggests that it is changes in the female reproductive system that somehow alter sleep. Depression and anxiety are also more common in women at these times, and insomnia is a common symptom of these psychiatric illnesses. 

Possible gene-interactive alterations in 5-HT function and BDNF expression was recently evaluated in mice with a combined manipulation of the genes for 5-HTT and BDNF. Male but not female 5-FlTT -BDNF DKO mice showed further decreases in brain 5-HT concentrations as well as further increases in anxiety-like behavior and stress reactivity compared to 5-HTT -BDNF controls (Murphy et al. 2003). These findings support the notion of critical role of gene-gene interaction in brain plasticity related to anxiety and related disorders. 

There is also evidence for both the familial aggregation and heritability of generalized anxiety disorder (GAD) in a limited number of studies. There is a five-fold average increase in the rister of GAD among relatives of probands with GAD compared to that among relatives of controls 5 (Mendlewicz et al. 1993 Noyes et al. 1987) and the heritability of GAD among female twins is 0.32 (Kendler et al. 1992). 

Fig. 3A, B Neuropeptide effects on anxiety-related behavioiu. A The oxytocin receptor antagonist (black bars) administered intracerebroventricularly (i.c.v.) increased indices of anxiety-related behaviour in pregnant rats as measured on the elevated plus maze. Entries into the closed arms indicate unchanged locomotor activity. B Prolactin is an anxiolytic neuropeptide in female rats as revealed by i.c.v. administration of synthetic prolactin (grey and black bars represent two different doses) and by antisense targeting of the prolactin receptor (R). Vehicle (white bars) vs mixed bases (grey bars) and antisense oligodeoxynu-cleotide (black bars). p<0.05 vs vehicle (white bars). (Adapted from Nemnann et al. 2000) and Torner et al. 2001)...

Risk factors Treatment factors treatment duration > 6 months high dose short-acting drug abrupt cessation Patient factors severe premorbid anxiety alcohol/substance use disorder female dysfunctional personality panic disorder... 

Mirtazapine is an antidepressant with a novel mechanism of action affecting both 5-HT and noradrenergic function. A recent systematic, open-label study found that 9 (34.6%) of 26 subjects (5 females, 21 males mean age, 10.1 +/— 4.8 years, age range 3.8-23.5 years) with autistic disorder and other PDDs were much improved or very much improved on the CGI after a mean duration of treatment of 5 months (Posey et al., 2001). The dosage range for mirtazapine was 7.5 to 45 mg/day with a mean daily dose of 30.29 mg +/— 12.64 mg. Target symptoms of aggression, self-injury, irritability, hyperactivity, anxiety, depression, and insomnia showed improvement. Adverse effects were transient and minimal and included increased appetite, irritability, and sedation. Based upon these preliminary data, a double-blind, placebo-controlled trial appears warranted. 

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