Generalized Anxiety Disorder (Gad)

The generalized anxiety disorder (GAD) is characterized by excessive anxiety and worry occurring with respect to a variety of activities or events at least ? 6 months. The cause is unknown, but there are often comorbid with alcohol abuse, major depression or panic disorder. Diagnosis is based on history and physical examination. The treatment consists of psychotherapy and / or pharmacotherapy.

The GAS is very common with a 1-year prevalence of about 3%. Women are twice as often affected as men. Although the disorder usually begins in childhood or early adolescence, but it can strike at any age.

The generalized anxiety disorder (GAD) is characterized by excessive anxiety and worry occurring with respect to a variety of activities or events at least ? 6 months. The cause is unknown, but there are often comorbid with alcohol abuse, major depression or panic disorder. Diagnosis is based on history and physical examination. The treatment consists of psychotherapy and / or pharmacotherapy. The GAS is very common with a 1-year prevalence of about 3%. Women are twice as often affected as men. Although the disorder usually begins in childhood or early adolescence, but it can strike at any age. Symptoms and signs The focus of concern is not limited as with other mental disorders (such as suffering a panic attack to embarrass in public or to be contaminated.); the patient has multiple worries that often change over time. Major concerns often relate to issues such as work and family responsibilities, finance, health, safety, car repairs and Hausa wide. The course is usually chronic fluctuating, with symptoms worsen under stress. Many patients with GAS have one or more comorbid psychiatric disorders, including major depression, specific phobia, social phobia and panic disorder. Diagnosis Clinical criteria The diagnosis is made clinically based on the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Patients have excessive, almost daily occurring fears and concerns about a variety of activities or events. Patients have difficulty controlling the worry on the majority of days for ? 6 months. The concerns must also ? 3 be related to the following: restlessness or a sense of irritability or nervousness Light fatigue difficulty concentrating irritability muscle tension sleep disorders The anxiety and worry can not be explained by drug use or other medical disorder (such as hyperthyroidism.) become. Treatment antidepressants and benzodiazepines often Certain antidepressants, including SSRIs (eg. As escitalopram, Initaildosis 10 mg PO once daily) and serotonin-norepinephrine reuptake inhibitor (z. B. retarded venlafaxine dose 37.5 mg PO once daily) are effective, but typically only if they are taken at least several weeks. Benzodiazepines (anxiolytics-see table: benzodiazepines) in low or moderate doses often also act and faster effective; However, long-term use can lead to physical dependence. A treatment strategy is to start with the combination of a benzodiazepine and an antidepressant. Once the effect of the antidepressant used, the benzodiazepine is tapered off. Buspirone is also effective; The starting dose is 5 mg p.o. 2 or 3 times / day. However, the effect of buspirone may occur after about 2 weeks. Psychotherapy, usually cognitive behavioral therapy can be both supportive and problem-oriented. Relaxation exercises and biofeedback can be helpful; However, their effectiveness has been demonstrated in only a few studies. Benzodiazepine drugs initial oral dose oral maintenance dose * onset / duration † alprazolam 0.25 mg 2 times / day Retard: 0.5 mg of 1-times daily 1 mg 3 times / day Retard: 3 mg of 1-times daily intermediary / intermediate chlordiazepoxide ‡ 5 mg 3 times / day 25 mg 3 times / day intermediary / long clone azepam † 0.25 mg of 1-times daily 1 mg 3 times / day intermediary / long clorazepate ‡ 7.5 mg of 2 times / day 7.5 mg 3 times / day or 15 mg 2 times / day single dose ( sustained release): 22.5 mg once daily after stabilization at 7.5 mg 3 times / day Quick / long ‡ diazepam 2 mg 3 times / day 5 mg 3 times / day Quick / long lorazepam 0.5 mg 3 times / day 1 mg 3 times / day intermediary / short oxazepam 10 mg 3 times / day 15 mg 4 times / day slow / short * The maintenance dose can vary and depends on the individual response. † There are a melt tablet or wafer is available. The onset of action differs from other formulations. Although these tablets dissolve in the mouth, they are absorbed as standard tablets in the stomach and intestines. ‡ In general, these drugs are not recommended in elderly patients due to a long half-life.

Health Life Media Team

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