Anxiolytics

Question 1

short acting: alprazolam (xanax)

intermediate: lorazepam (ativan), chlordiazepoxide (librium)
long: diazepam (valium), clonazepam (klonopin)

Answer 1

benzo- acute and
lorazepam good for catatonia

all produce active metabolites except Lorazepam, oxazepam, temazepam (use in alcoholics, liver disease)

serious withdrawal symptoms (seizure, rebound anx), when discontinued- must taper slowly over months (worse with short acting)

longer acting have less risk of dependence and withdrawal

careful with elderly- reduce motor coordination

Question 2

buspirone (buspar)

Answer 2

anx prophylax
partial 5HT1 agonist
not considered as effective, so commonly used in combo with another agent (SSRI, etc)

slower onset of action- max effect seen 4-6 weeks

not assoc with abuse, dep, or withdrawal

Question 3

propranolol

Answer 3

BB, tx autonomic effects of panic attacks/anx= palp, sweating, tachy
also good for tx akathisia