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Chapter 57: Anxiety Disorders

A 40-year-old woman complains of nervousness that lasts all day, back and neck pain, and difficulty sleeping through the night. She constantly worries about losing her job as an accountant despite the fact that she recently received a promotion. She has had difficulty concentrating at work, and it is tax season. These symptoms have progressively worsened in the past 7 months.

The psychiatrist is seeking a recommendation for this new diagnosis of generalized anxiety disorder. Which medication has an FDA indication for this disorder?

a. Alprazolam

b. Amitriptyline

c. Bupropion

d. Escitalopram

e. Fluvoxamine

Answer d is correct. Escitalopram has an FDA indication for generalized anxiety disorder.

Answer a is incorrect. Alprazolam is only indicated for anxiety/panic disorder.

Answer b is incorrect. Amitriptyline is only indicated for depression.

Answer c is incorrect. Bupropion is only indicated for depression, depression associated with seasonal affective disorder and smoking cessation.

Answer e is incorrect. Fluvoxamine is only indicated for obsessive compulsive disorder.

A 40-year-old woman complains of nervousness that lasts all day, back and neck pain, and difficulty sleeping through the night. She constantly worries about losing her job as an accountant despite the fact that she recently received a promotion. She has had difficulty concentrating at work, and it is tax season. These symptoms have progressively worsened in the past 7 months.

The mechanism of action of escitalopram is:

a. Dopamine 2A partial agonist

b. Selective serotonin reuptake inhibitor

c. Serotonin and norepinephrine reuptake inhibitor

d. Serotonin 1A partial agonist

e. Serotonin and dopamine antagonist

Answer b is correct. Escitalopram works primarily by acting as a selective serotonin reuptake inhibitor.

Answers a, c, d, and e are incorrect. Escitalopram does not have any action at neither the dopamine nor the norepinephrine receptors and is not a partial serotonin 1A partial agonist.

Which of the following benzodiazepines has the longest duration of action at steady state?

a. Alprazolam

b. Clonazepam

c. Diazepam

d. Triazolam

e. Lorazepam

Answer c is correct. Diazepam has multiple ...

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