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17 - Anxiety

from Part II - Targets of Pharmacotherapy

Published online by Cambridge University Press:  19 October 2021

Joseph F. Goldberg
Affiliation:
Icahn School of Medicine at Mount Sinai, New York
Stephen M. Stahl
Affiliation:
University of California, San Diego
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Summary

Ostensibly innocuous, yet deceptively so, like Monty Python’s fabled Killer Rabbit of Caerbannog (but with no Holy Hand Grenade of Antioch to lob as a countermeasure), anxiety often stands underappreciated for its pernicious and often devastating ill effects. Less profound and baffling than the perceptual and ideational anomalies of psychosis, less emotionally wrenching or blatantly lethal than suicidal melancholy, and less relentlessly haunting than the psychic sequelae of trauma, anxiety may be the prime example of a normal human emotion gone awry. While “normal” anxiety cues vigilance to environmental threats, demands, and rewards, aberrant anxiety paralyzes cognitive function, over-rides judgment, subverts harm appraisal, drives impulsive action, and generally worsens the prognosis and treatment responsiveness of any coexisting psychiatric problem. It is also easily mistaken for other forms of psychopathology that involve autonomic hyperarousal and psychomotor activation, potentially driving wrong pharmacotherapy decisions.

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Chapter
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Practical Psychopharmacology
Translating Findings From Evidence-Based Trials into Real-World Clinical Practice
, pp. 400 - 424
Publisher: Cambridge University Press
Print publication year: 2021

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