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Chapter 57. Anxiety Disorders
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A 27-year-old woman complains of excessive worrying, poor concentration, back and neck pain, and difficulty sleeping through the night. She constantly worries about losing her job as a data analyst despite the fact that she recently received a promotion. These symptoms have progressively worsened in the past 7 months and have negatively affected her relationship with her friends.
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The psychiatrist is seeking a recommendation for this new diagnosis of generalized anxiety disorder. Which medication has an FDA indication for this disorder?
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Answer d is correct. Buspirone has an FDA indication for generalized anxiety disorder.
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Answer a is incorrect. Levomilnacipram is only indicated for major depression.
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Answer b is incorrect. Amitriptyline is only indicated for depression.
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Answer c is incorrect. Bupropion is only indicated for depression, depression associated with seasonal affective disorder and smoking cessation.
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Answer e is incorrect. Fluvoxamine is only indicated for obsessive compulsive disorder.
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A 27-year-old woman complains of excessive worrying, poor concentration, back and neck pain, and difficulty sleeping through the night. She constantly worries about losing her job as a data analyst despite the fact that she recently received a promotion. These symptoms have progressively worsened in the past 7 months and have negatively affected her relationship with her friends.
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The mechanism of action of buspirone is:
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a. Dopamine 2A partial agonist
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b. Selective serotonin reuptake inhibitor
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c. Serotonin and norepinephrine reuptake inhibitor
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d. Serotonin 1A partial agonist
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e. Serotonin and dopamine antagonist
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Answer d is correct. Buspirone works primarily by acting as a serotonin 1A partial agonist.
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Answers a, b, c, and e are incorrect. Buspirone has no action at dopamine or norepinephrine receptors and does not selectively inhibit the reuptake of serotonin.
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Which of the following benzodiazepines has the longest duration of action at steady state?
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Answer c is correct. Diazepam has multiple metabolites which extends the half-life when administered in multiple doses.
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