Anxiety disorders include a constellation of disorders in which anxiety
and associated symptoms are experienced at level of severity that impairs
Types of Anxiety Disorder
1.Generalised Anxiety Disorder.
2.Social Anxiety Disorder.
3.Post Trauma Stress Disorder
Noradrenergic model :
The locus ceruleus may have a role in regulating anxiety, as it activates
norepinephrine (NE) release and stimulates the sympathetic and
parasympathetic nervous systems.
Chronic noradrenergic overactivity downregulates
α2 adrenoreceptors in patients with generalized anxiety disorder (GAD) and
posttraumatic stress disorder (PTSD).
Patients with social anxiety disorder (SAD) appear to have a
hyperresponsive adrenocortical response to psychological stress.
γ- aminobutyric acid (GABA) receptor model:
Anxiety symptoms may be linked to underactivity of GABA systems or
downregulated central BZ receptors.
Abnormalities of GABA inhibition may lead to increased response to stress
in PTSD patients.
Serotonin (5-HT) model:
The 5-HT and 5-HT2 antagonist meta-chlorophenylpiperazine (m-CPP)
causes increased anxiety in PTSD patients.
Dysregulation of the hypothalamic-pituitary-adrenal axis may be a risk
factor for eventual development of PTSD.
Generalized Anxiety disorders:
Psychological and congnitive :
Excessive anxiety, Poor concentration or mind going blank.
Restlessness, Fatigue, Sleep disturbance, Irritability
Social Anxiety Disorder
Some feared situations
Eating or writing in front of others, Interacting with authority
figures, Speaking in public,
Diarrhea, Sweating, Tachycardia
Posttraumatic stress disorder:
Physical and mental status examination.
Patients with GAD have irritable bowel syndrome.
Anxiety symptoms may associated with medical illness
Anxiety symptoms may psychiatric illnesses
Non drug Treatment:
Short –term counseling
Pharmacological Treatment for Generalized Anxiety Disorder
Pharmacological Treatment for Social Anxiety Disorder
Pharmacological Treatment of Post Trauma Stress Disorder
Benzodiazepines: sedation, vertigo , increased appetite weight gain.
Antihistamines: confusion,nausea, constipation.
β- blockers - bradycardia,wheezing
BZs : The combination of BZs with alcohol or other CNS depressants
may be fatal.
Antacids - decreased rate of benzodiazepine absorption
β blocker :combination with cimitidine increase metabolism of propranolol.