NRNP 6665 Week 3 Assignment: Generalized Anxiety Disorder

NRNP 6665 Week 3 Assignment: Generalized Anxiety Disorder

NRNP 6665 Week 3 Assignment: Generalized Anxiety Disorder

 Generalized Anxiety Disorder

Generalized anxiety disorder is a psychological disorder characterized by persistent, unrealistic, and constant worry that is not engrossed in a specific situation or object (Munir & Takov, 2022). Treatment of generalized anxiety disorder involves the use of pharmacological interventions and non-pharmacological interventions. Selective serotonin reuptake inhibitor (SSRI) antidepressants are the first-line medications in treating generalized anxiety disorder. Duloxetine is a selective norepinephrine reuptake inhibitor (SNRI) that is FDA approved for treating generalized anxiety disorders in children and adolescents (Dhaliwal et al., 2022). Buspirone is an off-label anxiolytic drug for treating generalized anxiety disorder in children and adolescents (Wilson & Tripp, 2022).

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Duloxetine is FDA approved for children between 7 and seventeen years old; therefore, the patient’s age is a major consideration before prescribing duloxetine (Dhaliwal et al., 2022). Children have been prescribed a starting dose of 30mg once daily for two weeks, after which the dose might be increased up to 120mg with increments of 30mg daily. On discontinuation, the dose should gradually be reduced since abrupt discontinuance causes fatigue, vomiting, nausea, anxiety, diarrhea, headache, paraesthesia, and dizziness. Duloxetine increases the risk of suicidal thoughts in children and adolescents; therefore, it should be monitored for any behavioral and mood changes. The risk of suicidal thoughts is higher during dosage alterations and in the early phases of therapy. The physician must inform the patient’s parents, family, or guardian about the risk of suicidal ideation and how to observe for changes in behavior. Duloxetine causes life-threatening serotonin syndrome, managed by discontinuing treatment and initiating supportive therapy.

Buspirone use in children and adolescent patients with generalized anxiety disorder depends on the risks versus the benefits. The initial dose in pre-adolescents is about 2.5mg to 5mg per day, while the initial dose in adolescents is 5mg to 10mg per day. The dose in pre-adolescents may be increased by 2.5mg every four days up to 20mg per day, while the dose in adolescents may be increased by 5mg per day at weekly intervals up to 60mg per day every eight or twelve hours. Buspirone has the risk of causing cognitive-motor impairment, hepatic failure, renal failure, and restless syndrome (Wilson & Tripp, 2022).

Non-pharmacological interventions used to treat and manage generalized anxiety disorder in children and adults include patient, behavioral, and cognitive-behavioral therapy (Munir & Takov, 2022). The child or adolescent is scheduled for weekly outpatient therapy sessions every four months. Behavioral techniques include in vivo exposure, modeling, relaxation training, and imagining and visualizing. Cognitive techniques used include challenging irrational beliefs and modifying self-talk. Parents are advised to be part of the therapy sessions.

Guidelines by the US Preventive Services Task Force recommend screening for anxiety in children above eight and depression in children above twelve. I recommend that children and adolescents on pharmacological interventions for generalized anxiety disorder must be treated using non-pharmacological interventions. Children and adolescents with less severe generalized anxiety disorder can initially be managed using non-pharmacological interventions only as their progress is monitored. Dosage of prescribed medications must be based on the patient’s age, weight, and disorder severity. The patient’s family should be involved in the therapy sessions to ensure they understand their condition. Children and adolescents are at a crucial stage in their life that require gentle care. The individual therapy sessions should aim to understand the patient’s living situation in case of any triggers. A patient’s treatment must focus on identifying a patient’s trigger factors.

References

Dhaliwal JS, Spurling BC, Molla M. Duloxetine. [Updated 2022 May 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549806/

Munir S, Takov V. Generalized Anxiety Disorder. [Updated 2022 Jan 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441870/

Wilson TK, Tripp J. Buspirone. [Updated 2022 Mar 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK531477/

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Assignment GAD Generalized anxiety disorder

• Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
• Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
• Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
• Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.