Anxiolytic Drugs

Question 1

buspirone

Answer 1

TRADE: BuSpar, Vanspar
CLASS: anxiolytic, serotonin receptor agonist
FDA approval: short-term tx of GAD & to relieve symptoms of anxiety with/without accompanying symptoms of depression
MAIN points:
1) most commonly used to enhance effect of SSRI and SNRI antidepressant
2) milder side effects and lower risk of withdrawal compared to popular antianxiety drugs
3) because of the lower risk of abuse and addiction, often is prescribed for people with hx of substance abuse who need tx for anxiety disorder
4) not recommended in the presence of significantly impaired hepatic or renal functioning
5) do not use with MAOIs or grapefruit products

Question 2

alprazolam

Answer 2

TRADE: Xanax
CLASS: benzodiazepine
FDA approval: tx of panic disorder with or without agoraphobia & acute tx of GAD
MAIN points:
1) not common to OD on this alone but use with other CNS depressants can be fatal
2) abrupt discontinuation of the med can be fatal, seizures may occur
3) high potency, rapid absorption, fast acting (short half-life)

Question 3

venlafaxine

Answer 3

TRADE: Effexor
CLASS: selective serotonin and norepinephrine reuptake inhibitor (SNRI)
FDA approval: MDD, GAD, SAD, & PD
MAIN points:
1) great absorption
2) precautions needed due to increase in suicidal ideation esp in younger individuals & risk of serotonin syndrome and increase in blood pressure
3) no strong evidence of addiction, dependence, or mortality except for amphetamine-like high

Question 4

propranolol

Answer 4

TRADE: Inderal, Hemangeol
CLASS: beta blocker
FDA approval: hypertension only –> but off-label uses = GAD, social anxiety (stage fright), PTSD (possibly)
MAIN points:
1) does not treat mental symptoms of GAD but helpful in physical symptom tx
2) normal side effects are dizziness and nausea but this often subsides after regular usage
3) should be slowly weened off, cutting off abruptly could lead to heart issues