Module 9 Lecture 4

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<p>Cannabinoids and Health</p><p>Module 9</p><p>Lecture 4: Treatments for Anxiety</p><p>Traditional Treatments for</p><p>Anxiety: Overview</p><p>• Pharmacological and psychosocial treatments are both</p><p>common and show some efficacy for certain patients</p><p>• Pharmacological treatments:</p><p>• SSRIs and SNRIs</p><p>• Benzodiazepines</p><p>• Beta-blockers</p><p>• Psychosocial treatments:</p><p>• CBT</p><p>• ACT</p><p>• Mindfulness</p><p>• Group Therapy</p><p>• Exposure Therapy</p><p>• DBT</p><p>www.anxiety.org</p><p>Pharmacological Treatments</p><p>• SSRIs and SNRIs</p><p>• initially prescribed as antidepressants</p><p>• recent research suggests efficacy with anxiety</p><p>• SSRI—block reuptake of serotonin</p><p>• SNRI—block reuptake of norepinephrine</p><p>www.anxiety.org</p><p>Pharmacological Treatments</p><p>• Benzodiazepines</p><p>• Work on GABA-system to promote sleep, relaxation,</p><p>decrease in anxiety, improvement in mood (acutely)</p><p>• Fast-acting, tend to be habit-forming</p><p>• Abuse liability, especially in people with addiction history</p><p>• Beta-blockers</p><p>• Decrease heart rate</p><p>• Usually used only in performance-anxiety situations</p><p>(e.g., public speaking)</p><p>www.anxiety.org</p><p>Psychosocial Treatments for</p><p>Anxiety</p><p>• Exposure Therapy</p><p>• Treatment of choice for many anxiety disorders—can be</p><p>highly effective for PTSD, phobias, OCD</p><p>• Gradually exposes individual to the feared situation in a</p><p>safe, controlled environment.</p><p>• Eliminating the actual fear is the ultimate goal.</p><p>• Begin by having the patient repeatedly imagine the</p><p>feared situation or object and potential responses to it</p><p>• Work up “fear hierarchy”</p><p>• Group Therapy</p><p>• normalizes individual's experience by relating to others</p><p>• offers alternative for those who are unable to afford</p><p>one-on-one therapy.</p><p>www.anxiety.org</p><p>Psychosocial Treatments for</p><p>Anxiety</p><p>• CBT (Cognitive Behavior Therapy)</p><p>• focuses on identifying, understanding, and changing thinking</p><p>and behavior patterns related to anxiety</p><p>• develop coping skills</p><p>• record their thoughts throughout the week as they occur</p><p>• can be used to support exposure therapy</p><p>• ACT (Acceptance and Commitment Therapy)</p><p>• About both acceptance and change</p><p>• Letting go of struggle to control unwanted thoughts and</p><p>feelings</p><p>• Being mindfully aware of the present moment</p><p>• Committing to a course of action that is consistent with</p><p>values</p><p>www.anxiety.org</p><p>Psychosocial Treatments for</p><p>Anxiety</p><p>• DBT (Dialectical Behavior Therapy)</p><p>• Is a specific type of CBT</p><p>• The term "dialectics" refers to a philosophical practice of</p><p>examining multiple or often contradictory ideas, combining</p><p>acceptance and change simultaneously.</p><p>• patient can accept where she is in her life and also feel</p><p>motivated to improve it</p><p>• emphasis on mindfulness, enabling people to recognize and</p><p>attempt to understand thoughts as they occur</p><p>• Mindfulness/meditation</p><p>• conscious practice of focusing your thoughts in one specific</p><p>direction, redirecting them when they begin to wander</p><p>• “attention training”</p><p>• focus on present moment</p><p>www.anxiety.org</p><p>However….</p><p>• Treatment response rates to these standard</p><p>treatments are less than optimal, with up to 60% of</p><p>patients continuing to have residual anxiety</p><p>symptoms (Bandelow et al.,2008)</p><p>• Medications are also associated with significant</p><p>side effects leading to noncompliance and</p><p>discontinuation (Olfson, et al., 2006)</p><p>• Psychotherapy can also be costly and time-</p><p>consuming</p><p>Summary</p><p>• Numerous treatment options for anxiety</p><p>• Pharmacological options are effective for some</p><p>people, but have some negative side effects</p><p>• Psychosocial options can be expensive and time-</p><p>consuming, and can often be highly aversive for</p><p>people with anxiety</p><p>• Alternative treatments currently have</p><p>demonstrated limited efficacy</p><p>• Largely due to limited research</p><p>• Cannabinoids may be a promising new avenue of</p><p>research in this area</p>