Anxiolytics Flashcards
Which classes of drugs can be used as anxiolytics?
Beta-blockers (physical symptoms)
Benzodiazepines
Pregabalin
Antidepressants
How do beta-blockers work in anxiety?
Reduces autonomic nervous system activation
Bio-psycho feedback
Used for short-term anxiety and not useful for enduring anxiety disorders
What is the most commonly used beta blocker in psychiatry?
Propanolol
Who are beta-blockers often misused by?
musicians, actors, snooker players
Are beta-blockers fatal in overdose?
yes
What are the contraindications of beta-blockers?
Asthma
Heart block
Which benzodiazepines are typically used in psychiatry?
Diazepam (long half-life)
Lorazepam (short half-life)
How do benzodiazepines work?
They potentiate the effect of GABA by binding to GABA receptors and therefore reduce the excitability of neurones
(positive allosteric modulation)
What are the side effects of BDZs?
Drowsiness/sedation/coma
Potential for tolerance and dependence
Significant potential for misuse
Use very cautiously and no more than 6 weeks
Occasionally paradoxical disinhibition (sedation of the frontal lobe)
What is the action of pregabalin?
Binds to voltage-gated calcium channels on neurones
Increases extra-cellular amounts of the enzyme responsible for the synthesis of GABA
Increases GABA concentrations which reduces neuronal activity
Can pregabalin be misused?
Less potential for dependence and misuse
But often still misused
What are the side effects of pregabalin?
Sedation
Weight gain
Ataxia
Very few interactions making combinations easier
How are antidepressants used in anxiety disorders?
SSRIs most commonly used
Similar doses for anxiety as with depression
Typical doses for OCD tend to be higher
Most common and generally effective way to treat anxiety disorders
