AANP Family Nurse Practitioner (FNP) Certification ExamPlanMedium
A 45-year-old female presents with a 3-month history of generalized anxiety disorder. She reports difficulty sleeping, restlessness, and persistent worry. She has tried relaxation techniques and exercise with minimal improvement. She has no significant medical history or contraindications. Which of the following pharmacological agents is the most appropriate initial treatment?
- ASertraline
- BAlprazolam
- CHydroxyzine
- DBupropion
Show answer & explanationAnswer & explanation
Correct answer: A. Sertraline
Selective serotonin reuptake inhibitors (SSRIs) like sertraline are considered first-line pharmacological treatment for generalized anxiety disorder due to their efficacy, favorable side effect profile, and non-addictive nature. They require consistent use for several weeks to achieve full therapeutic effect.
Why the other options are wrong
- B. Alprazolam is a benzodiazepine, typically used for acute anxiety or short-term management due to its rapid onset but carries risks of dependence and withdrawal, making it less suitable for initial long-term GAD treatment.
- C. Hydroxyzine is an antihistamine with sedative properties used for short-term anxiety relief, but it is not considered a first-line agent for chronic generalized anxiety disorder due to its sedating effects and lack of sustained anxiolytic action.
- D. Bupropion is an antidepressant primarily used for major depressive disorder and smoking cessation, but it is generally not effective for generalized anxiety disorder and can sometimes worsen anxiety.
GAD First-Line Pharmacotherapy
SSRIs and SNRIs are the recommended first-line pharmacological treatments for generalized anxiety disorder.
- Require 4-6 weeks for full therapeutic effect.
- Dosage adjustments may be needed.
- Benzodiazepines are typically reserved for short-term or acute symptom management.
Memory trick: Anxiety's First Line: SSRIs and Talk.