Which medication would be considered a first-line medication therapy for generalized anxiety disorder (GAD)?

Choice A reason: Minimizing suicide as drastic dismisses the patient’s emotional pain, linked to serotonin deficits and amygdala hyperactivity in depression. This lacks empathy, risking alienation and worsening despair, as it fails to acknowledge the neurobiological severity of suicidal ideation, making it inappropriate.

Choice B reason: Acknowledging intense upset validates the patient’s emotional state, reflecting serotonin-driven despair in suicide attempts. Empathy, engaging mirror neurons, fosters trust and reduces isolation, aligning with therapeutic principles to support neurobiological stabilization and emotional recovery in psychiatric care.

Choice C reason: Offering to solve problems focuses on solutions, not empathy. Suicidal ideation, tied to prefrontal cortex dysfunction, requires emotional validation first. This statement risks dismissing feelings, reducing therapeutic connection, and is less effective than acknowledging the patient’s emotional distress.

Choice D reason: Expressing personal sadness shifts focus to the nurse’s feelings, not the patient’s. Empathy requires reflecting the patient’s emotional state, like despair from serotonin imbalances, to build rapport. This statement, while sympathetic, is less empathic, making it incorrect for demonstrating true empathy.

Choice A reason: Buspirone is not used as needed; it requires weeks for serotonin modulation to reduce anxiety. Diazepam’s rapid GABA enhancement suits acute use. Buspirone’s chronic dosing schedule makes this characteristic incorrect for explaining its preference over diazepam for long-term anxiety management.

Choice B reason: Buspirone is slower-acting, taking weeks to enhance serotonin activity, unlike diazepam’s rapid GABA-mediated effects. For anxiety driven by amygdala hyperactivity, diazepam acts faster, making buspirone’s slower onset an incorrect reason for its prescription over diazepam in this context.

Choice C reason: Blood dyscrasias are not a known side effect of buspirone, which primarily affects serotonin receptors. This is unrelated to its preference over diazepam, which carries dependence risks. This characteristic is inaccurate and irrelevant to the rationale for choosing buspirone.

Choice D reason: Buspirone’s lack of dependence risk, unlike diazepam’s GABA-mediated addiction potential, makes it safer for long-term anxiety management. By enhancing serotonin in the prefrontal cortex, it reduces chronic anxiety without habit-forming effects, aligning with its preference for sustained treatment, making this the correct reason.