Anxiolytics Flashcards
How do benzodiazepines work?
Bind to GABA receptors and enhance the action of GABA (inhibition)
Effects of benzodiazepines Always Another Stupid Mnemonic About Amnesia
(reduce) Anxiety
(reduce) Aggression
Sedation
Muscle relaxant
Anti-convulsant
Anterograde amnesia
What is anterograde amnesia
Inability to form new memories after the (event causing) amnesia
Main inhibitory transmitter in the brain
GABA
How does GABA work?
Causes hyperpolarisaion of target cells (allows Cl- to enter)
Antagonist to benzodiazepines (i.e. could give if you overdose)
Flumazenil
Name 2 SSRI’s you could prescribe for generalised anxiety disorder
- escitalopram
- paroxetine
If someone overdoses on benzos what could you give them?
Flumazenil
How to withdraw benzodiazepines
1) Transfer patient to equivalent daily dose of diazepam/chlordiazepoxide preferably taken at night
2) Reduce dose every 2–3 weeks in steps of 2 or 2.5mg; if withdrawal symptoms occur, maintain this dose until symptoms improve
3) Reduce dose further, if necessary in smaller steps; it is better to reduce too slowly rather than too quickly
4) Stop completely; time needed for withdrawal can vary from about 4 weeks to a year or more
Benzodiazepines and monoamines
Benzodiazepines block increases of NA and 5-HT release
Name a 5-HT1A agonist
Busipirone
What can happen if you withdraw benzodiazepines rapidly?
Rapid withdrawal may cause confusion, toxic psychosis and even convulsions
SSRI’s for GAD?
Escitalopram, paroxetine
you could also use venlaxafine and this may help prevent subsequent development of depression
Drugs for OCD
SSRI’s
TCA’s
Driving and benzodiazepines
Patients should be advised not to drive when on benzos
