SudaMediCa, The Sudanese Medical Community

A 28-year-old woman presents to your clinic
complaining of feeling “on edge.” Upon further
questioning, you discover that she has also
noticed problems with irritability, insomnia,
fatigue, and restlessness. She also has a history
of worrying about things that seem to not
bother those around her. She states these symptoms
have been present for years but have
recently become worse. When you try to gather
more information, she interrupts to say that
she cannot stay much longer because she is
afraid that she will lose her new job as a
machinist.

هانى ,, اسماعيل ,, د. سودان ,,
إيناس ,,
و بقية فطاحلة سوداميديكا
discuss please

I'll post the Answer and explanation at midnight GMT +3

I think the scenario of a generalised anxiety disorder ( GAD ) --- The best choice is diazepam because she has insomnia.Since we are not told that she is benzodiazapine naive or not , we assume that she has not taken it before and therefore the first choice should be buspirone (a none benzodiazepine anxiolytic- does not cause dependence but it does not improve sleep ! ) , this is why I think diazepam is the best answer but the disadvantage is that it causes dependence!.

The answer is (E) (Buspirone) This patient’s symptoms are consistent with
an anxiety disorder. Given her occupation, an
anxiolytic medication with no sedative properties
would be most preferable. Buspirone is a
nonsedating anxiolytic agent that is a partial
agonist at 5-HT1A receptors. Unlike benzodiazepines,
such as diazepam and oxazepam
(Serax), it has no hypnotic, anticonvulsant, or
muscle relaxant properties. Amitriptyline and
doxepin have also been used to treat anxiety,
especially when associated with depression;
however, these drugs are also sedating