Anxiety interventions

Respiratory alkalosis is the rise in pH associated with excessive respiration. Hyperventilation, which can result from anxiety or high fever, is a common cause. The body may control blood pH during hyperventilation by fainting, which results in slower respiration. An intervention that may prevent fainting is to have a hyperventilating person breathe into a paper bag, which allows much of the respired CX)2 to be taken up again. 

Ciraulo DA, Jaffe JH Tricyclic antidepressants in the treatment of depression associated with alcoholism. Clin Psychopharmacol 1 146—150, 1981 Ciraulo DA, Nace E Benzodiazepine treatment of anxiety or insomnia in substance abuse patients. Am J Addict 9 276—284, 2000 Ciraulo DA, Barnhill JG, Jaffe JH, et al Intravenous pharmacokinetics of 2-hydroxy-imipramine in alcoholics and normal controls. J StudAlcohol 51 366-372, 1990 Ciraulo DA, Knapp CM, LoCastro J, et al A benzodiazepine mood effect scale reliability and validity determined for alcohol-dependent subjects and adults with a parental history of alcoholism. Am J Drug Alcohol Abuse 27 339—347, 2001 Collins MA Tetrahydropapaveroline in Parkinson s disease and alcoholism a look back in honor of Merton Sandler. Neurotoxicology 25 117-120, 2004 COMBINE Study Research Group Testing combined pharmacotherapies and behavioral interventions in alcohol dependence rationale and methods. Alcohol Clin Exp Res 27 1107-1122, 2003a... 

Rates of smoking among patients with bipolar disorders and anxiety disorders (e.g., posttraumatic stress disorder, panic disorder) are also higher than those in the general population (Lasser et al. 2000), but there has been htde smdy of the factors associated with motivation to quit smoking or of smoking cessation interventions in these patient groups. 

Since early detection and intervention in schizophrenia is important for maximizing outcomes, treatment with antipsychotic medications should begin as soon as psychotic symptoms are recognized. Antipsychotic medications are the cornerstone of therapy for people with schizophrenia, and most patients are on lifelong therapy since non-adherence and discontinuation of antipsychotics are associated with high relapse rates. If other symptoms are present such as depression and anxiety, these symptoms should also be aggressively treated. Additionally, psychosocial treatments should be used concomitantly to improve patient outcomes. 

Recommend psychotherapy and pharmacotherapy interventions for patients with generalized anxiety, panic, and social anxiety disorders. 

Robertson, C., Gatchel, R. and Fowler, C., Effectiveness of a videotaped behavioral intervention in reducing anxiety in emrgency oral surgery patients. Behavioral Medicine 17(2), 77-85, 1991. 

Causes of psychogenic ED include malaise, reactive depression or performance anxiety, sedation, Alzheimer s disease, hypothyroidism, and mental disorders. Patients with psychogenic ED generally have a higher response rate to interventions than patients with organic ED. 

Once chronic insomnia has developed, it hardly ever spontaneously resolves without treatment or intervention. The toll of chronic insomnia can be very high and the frustration it produces may precipitate a clinical depression or an anxiety disorder. Insomnia is also associated with decreased productivity in the workplace and more frequent use of medical services. Einally, substance abuse problems may result from the inappropriate use of alcohol or sedatives to induce sleep or caffeine and other stimulants to maintain alertness during the day. 

Antipsychotics or neuroleptics are used for intervention in patients with severe and chronic psychosis of an organic as well as induced nature. These drags are used for controlling manic phases in manic-depressive psychosis such as relieving anxiety, fear, excitement associated with somatic diseases, controlling aggression, tics, and other unequal conditions. 

Model Intervention Species Anxiety level Reference(s)... 

Sensitization Dopaminergic, noradrenergic NMDA receptors Nucleus accumbens, amygdala, striatum, hypothalamus May explain the adverse effects of early life trauma on subsequent responses to stressful like events. May play a role in the chronic course of many anxiety disorders and, in some cases, the worsening of the illness over time Suggests the efficacy of treatment may vary according to the state of evolution of the disease process. Emphasizes the importance of early treatment intervention... 

This remarkable lability of a memory trace, which permits a reorganization of an existing memory in a retrieval environment, provides a theoretical basis for both psychotherapeutic and pharmacotherapeutic intervention for traumatic stress exposure as well as other anxiety disorders. Administration of P-receptor and NMDA receptor antagonists shortly after trauma exposure or spontaneous panic attacks as well as after reactivation of memory associated with the anxiety-inducing event may reduce the strength of the original memory. 

For mild to moderate anxiety, we recommend the conservative approach of beginning with CBT and including medication if CBT is ineffective or only partially effective. However, severe anxiety that involves duress, prominent avoidance behavior, physiological symptoms, or marked impairment, requires a combination of CBT and medication as an initial intervention. Furthermore, children and families with low motivation (i.e., those unlikely to participate in CBT assignments) or having a poor subjective sense of anxiety may require medication treatment as one of the initial interventions. 

Barrett, P.M., Dadds, M.M., Rapee, R.M., and Ryan, S.M. (1996) Family intervention for childhood anxiety./ Consult Clin Psychol... 

Pharmacological treatment of anxiety disorders in individuals actively abusing substances is often difficult. Two to four weeks of abstinence is recommended, during which time alternative interventions can be initiated. Agents that have low abuse liability, such as the SSRls, TCAs, or buspirone (Buspar), are recommended. If benzodiazepines are clinically indicated, it... 

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