Definition:characterized by excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry
*** it is very common to have comorbid depression alongside anxiety disorders such as GAD ***
Classification / type of disease:
- 3% of the popn suffer with GAD in their lives
- Median age of onset is 31
- M:F – 1:2
Presenting symptoms / signs: fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, bouts of difficulty breathing, difficulty concentrating, trembling, twitching, irritability,agitation, sweating, restlessness, insomnia, hot flashes, and rashes and inability to fully control the anxiety
Diagnostic investigations: the above symptoms must co-exist and be present for >6/12 for a formal diagnosis to be made.
- Substance induced:longterm benzodiazepines and alcohol.
- Neurological disease
- CBT often in conjunction with medications
- SSRIs: fluoxetine, paroxetine, escitalopram, sertraline
- Pregabalin: acts on the voltage-dependent calcium channel in order to decrease the release of neurotransmitters such as glutamate, noradrenaline and substance P. Its therapeutic effect appears after 1 week of use and is similar in effectiveness to lorazepam, alprazolam and venlafaxine
- Other drugs which may work: Buspirone, duloxetine, imipramine, venlafaxine, propranolol