7.6 Pharmacology of Anxiety Disorders

Question 1

Anxiolytics

Answer 1

• Antianxiety medications (minor tranquilizers)

Treats
- Anxiety disorders
- Acute alcohol withdrawal
- Skeletal muscle spasms
- Convulsive disorders
- Status epilepticus
- Preoperative sedation

• These are sedatives, hypnotics, muscle relaxants and anticonvulsants.
• CONTRAINDICATED IN NARROW ANGLE GLAUCOMA
• CAN BE ADDICTIVE
• DEPRESSES CNS SYSTEM, INCREASES GABA.
• These promote relaxation and depress limbic system
• WARNING: ABRUPT WITHDRAWAL CAN BE LIFE THREATENING

Question 2

Anxiolytics

Answer 2

• Hydroxyzine
• Alprazolam
• Chlordiazepoxide
• Clonazepam
• Clorazepate
• Diazepam
• Lorazepam

Question 3

Medications for Panic and GAD

Answer 3

• Benzodiazepines, anxiolytics, antidepressants, antihypertensives
• Mainly benzodiazepines for anxiety

Benzodiazepines - All the -pams

Non-Benzodiazepines (Buspirone)

Side Effects
- Tolerance
- Orthostatic Hypotension
- Paradoxical Excitement
- Dry mouth, N/V
- Blood dyscarias
- Daytime sedation
- Dizziness
- Behavioral Change

Question 4

Major Anti-Anxiety Antidepressants

Answer 4

• Clomipramine
• Imipramine
• Tricyclics are not widely used due to severe side effects at high doses to relieve panic

Question 5

Phobic Disorder Medications

Answer 5

• Benzodiazepines for social phobia
• SSRIs (paroxetine and sertraline) are first-line treatments for social phobia

Question 6

OCD and Body Dysmorphic Medication

Answer 6

• Most often is antidepressants
• SSRIs (fluoxetine, paroxetine, sertraline, fluvoxamine)

Clomipramine
- Selective serotonin reuptaker

Question 7

Medications for Hair Pulling Disorder

Answer 7

• Chlorpromazine
• Amitriptyline
• Lithium Carbonate

Question 8

Benzodiazepine Withdrawal

Answer 8

• Restlessness
• Irritability
• Insomnia
• Hand Tremors
• Abdominal/Muscle Cramps
• Sweating
• Vomiting
• Seizures