Antiaxiety Flashcards
Two Types of Antianxiety Drugs
1) Anxiolytics aka Minor Tranquilizers (Benzodiazepines, Antidepressants, Beta Blockers, Antihistamines)
2) Sedative Hypnotics (Benzodiazepines, Barbiturates, Major Tranquilizers include antipsychotics)
a) Sedative: calm agitation
b) Hypnotic: induce sleep
c) Anxiolytic: reduce anxiety
Mechanisms of Action for Anxiety Drugs
1) GABAA System has 5 receptors:
* GABA, ETOH, Benzodiazepines, neurosteriods, and Barbiturates
2) Benzo’s bind with Benzodiazepines receptors
3) Trigger the opening of Cl- ion channels
4) Influx of Cl- ions enter the cell creating inhibitory effect
Chlodiazapoxide
Brand Name: Librium
Antianxiety: Benzidiazepines,
(the first one)
Half Life: 10 to 20 hours
Lorazepam
Brand Name: Ativan
Antianxiety: Benzodiazepines
Half Life: 10 to 20 hours
Very Addictive
Alprazolam
Brand Name: Xanax
Antianxiety: Benzodiazepines
Half Life: 8 to 15 hours,
fast action
Very Addictive
Diazepam
Brand Name: Valium
Antianxiety: Benzodiazepines
Half Life: 20 to 70 hours
Very Addictive
Clonazepam
Brand Name: Klonopin
Antianxiety: Benzodiazepines,
anticonvulsant
Half Life: 30 to 40 hours
Less Addictive, more popular
Oxazepam
Brand Name: Serax
Antianxiety: Benzodiazepines
Less Addictive
Prazepam
Brand Name: Centrax
Antianxiety: Benzodiazepines
Less Addictive
Halazepam
Brand Name: Paxipam
Antianxiety: Benzodiazepines
Less Addictive
Quazepam
Brand Name: Doral
Antianxiety: Benzodiazepines
Less Addictive
Flumazenil
Brand Name: Romazicon
Antianxiety: Benzodiazepines
Buspirone
Brand Name: BuSpar
Antianxiety: unique antianxiety agent, acts on 5HT receptor
Half Life: 2 to 3 hours and up to 11 hours
Propranolol
Brand Name: Inderal
Antianxiety: beta blocker, block NE receptors
Reduces heart rate, tremors, & sweating
Atenolol
Brand Name: Tenormin
Antianxiety: Beta blocker, block NE receptors
Reduces heart rate, tremors, & sweating
Estazolam
Brand Name: ProSom
Antianxiety: Sedative Hypnotic
Quazepam
Brand Name: Doral
Antianxiety: Sedative Hypnotic,
sleep aid
Zolpidem
Brand Name: Ambien
Antianxiety: Sedative Hypnotic, sleep aid
Short HL: 1.5 - 2.6 hours,
Less addictive, for chronic insomniacs
Zaleplon
Brand Name: Sonata Antianxiety: Sedative Hypnotic, sleep aid, Short HL: 1 -1.5 hours, Less addictive, for chronic insomniacs
Eszopiclone
Brand Name: Lunesta Antianxiety: Sedative Hypnotic, sleep aid, Short HL: 6 hours, Less addictive, for chronic insomniacs
Hydroxyzine
Brand Name: Atarax Antianxiety: Antihistamine, Block histamine receptors
Diphenhydramine
Brand Name: Benadryl Antianxiety: Antihistamine, Blocks histamine receptors
Sedative Hypnotic Withdrawal
1) Takes 6 months to rid of the withdrawal symptoms
2) Worse than alcohol withdrawal
3) Withdrawal symptoms makes it hard to get off of drug
4) Symptoms Include: hypertension, fever, insomia, hallucinations, anxiety, nausea, seizure, delirium, death
Drugs Used for Alcohol Withdrawal
Used for Alcohol Withdrawal due to its Moderate Half Life Chlodiazapoxide (HL: 10 to 20 hrs) Lorazepam (HL: 10 to 20 hours)
Drugs Used for Generalized Anxiety Disorder
1) Buspirone
2) Benzodiazepines
3) Antiseizure Medication such as Gabapentin
4) SSRI’s (antidepressants)
5) Tricyclic antidepressants
Drugs Used for Stress Induced Anxiety
1) Short-term used (1 to 4 weeks) of Benzodiazepines
2) Short term use of Sedative Hypnotics for sleep
Drug Used for Specific & Social Phobias
1) Exposure Therapy is better than any drug
2) Medication is not warranted
3) If use drugs then prescribe
a) Propranolol, a beta blocker
b) Venlafaxine, a SNRI
c) MAOI’s
d) SSRI’s (for social phobia)
Drugs Used for Agoraphobia without Panic
1) Use Exposure Therapy
2) Propranolol, a beta blocker
3) Benzodiazepines
Drugs Used for Panic Disorder
1) High potency Benzodiazepines (Clonazepam, Alprazolam & Lorazepam)
2) SSRI’s & SSNRI’s
3) Tricyclics
4) MAOI’s
Drugs Used for OCD
1) Clomipramine (commonly used)
2) High Dosage of SSRI’s
3) Combined SSRI & Clonazepam
4) Combined SSRI & other sedative hypnotic benzo’s
Maladaptive Loop of OCD
1) Frontal Cortex
2) Caudate Nucleus of the Basal Ganglia
3) Thalamus
4) Back to Frontal Cortex
Damage to this loop at the basal ganglia
Basal ganglia is rich in serotonin
People with OCD has less 5HT than People with MDD
Substances that Cause Anxiety Symptoms
1) Alcohol Withdrawal
2) Caffeine Use
3) Cocaine Use
4) Appetite Suppressants
Medical Conditions that Cause Anxiety Symptom
1) Cushing’s Syndrome
2) Hyperthyroidism
3) Premenstrual Syndrome
4) Cardiac Arrthymia
5) Alcoholism
