What is the neurobiological basis for fear and anxiety and how can you treat it (medication)?
Influence neurotransmitters
Adrenaline
Serotonine
Noradrenaline
GABA
Benzo’s
Dual pathway LeDoux
Prefrontal Cortex
Amygdala
Visual Cortex
Thalamus
Learning goals
Medication
o What medication do you apply to treat anxiety disorders?
o What medication can be used specifically for the different anxiety disorders?
- Anxiolytics
- Benzo’s (inhibits entire brain system, highly addictive)
- Beta-adrinerge blocker (inhibits alleen lichamelijke sensaties, less
addictive) = block transmission of stimuli and physical reactions will be
reduced which is caused by adrenergetic system. Beta-blockers for
social phobia to reduce reactions quicker. Catechonalines (bv
noradrenaline) stay longer in synaptische spleet. Blokkeren dat
catecholominen in de synaptische spleet terechtkomen. Block
adrenaline waardoor je geen fysieke sensaties hebt.
- Antidepressiva (first can increase anxiety)
- SSRIs: makkelijk in gebruik, minder invloed op andere neurotransmitters
en minder bijwerkingen daardoor. Niet gevoelig voor overdosis.
- TCA inhibit reuptake of 5HT neurotransmitter. Duurt een tijdje voordat
ze aanslaan en zorgt eerst voor symptomen die juist angst opwekken.
Easy to overdose.
- MAO – veel bijwerkingen waardoor weinig voorgeschreven voor
anxiety.
o How does the medication work? What are the side-effects and the pro and
cons? (Do not need to go into antidepressants to deep)
o Important names (what are ‘pammetjes’)
Biology
o Which biological models explain anxiety disorders? Which brain structures play
a role in anxiety? (Also look at the brain structures that play a role in emotion
regulation)
LeDoux
Fear network (artikel holsneider)
o What neuroimaging studies are there? Do they provide insight regarding
treatments for anxiety disorders. Tool for diagnosis en aan het einde van de
behandeling zien of het is afgenomen.
o Scan the task (in block book) for difficult words and apply knowledge that we
gained for the task.
Clark & Beck 2010
Neurobiological basis of fear and anxiety 1 important finding: the central role of the
amygdala in emotional processing and memory.
The amygdala is involved in