Lecture 19s - Drug Treatment And Anxiety

Question 1

What is the name of the group of drugs usually used to treat anxiety?

Answer 1

Sedative tranquillisers - so they send you to sleep in higher doses and reduces anxiety

Question 2

Name a group of anxiety reducing drugs that aren’t sedative tranquillisers

Answer 2

SSRIs

Question 3

Name 7 types of anxiolytics ranging back 1000s To the present day

Answer 3

Alcohol
Potassium bromide 
Barbiturates
Meprobamate
BZs
Propranolol 
SSRIs

Question 4

Describe a bit about alcohol as a anxiolytic, when was it most commonly used, what are it’s big problems etc

Answer 4

Been available for 1000s of years
Mostly commonly used in agricultural settings, when there were lots of things to ferment
The problem is that it’s short acting, and has a rebound (hangover) as well as side effects like impaired cognition, removal of inhibition

Question 5

Describe a little about potassium bromide

Answer 5

Discovered in the middle 1800s
Effective for anxiety and epilepsy
But there is a problem with accumulation within the body leading to bromism

Question 6

Describe barbiturates, discovered when, effective for, problems with…

Answer 6

Used from about the 1900s
Sedative and effective anxiolytic
It was the first mainstream drug prescribed to every day people
But there were problems with overdose and addiction , a little too much and you’d get respiratory depression.

Question 7

Describe meprobamate, discovered when, useful for, problems, effects on animals

Answer 7

Also known as miltown
Very similar action to BZs , also as pleasant to take
Discovered in the 1950s, coined the word tranquilliser
Better than barbiturates because it reduced anxiety without making you sleepy.
When given to mice it gave them flaccid muscle paralysis, but the mice didn’t seem to be bothered.
Given up on due to addictive qualities, but so were the drugs that replaced them.

Question 8

BZs, give examples, uses, pros & cons, what did it do to animals

Answer 8

Most famous was diazepam, but the first ever was chlordiazepoxide / Librium, when given to mice you could give them electric shocks and they wouldn’t be bothered.
Could also tame tigers and lions
Pleasant to take, only became a sedative in high doses, but low doses left people alert and normal.
Can’t really overdose
Very good muscle relaxants therefore very good for rapid anxiety relief
But - very addictive and abused intravenously. So now although it has a safer drug profile than most there is a lot of stigma over it.

Question 9

Describe the drug profile of propranolol

Answer 9

Beta blocker discovered in the 1960s, not a sedative or tranquilliser
Initially used lowered blood pressure, which is useful for anxiety as well because it reduces heart rate and the tremor of anxiety.
By blocking the sympathetic nervous system your body interprets this as you being not anxious. - indirect effect
Often used for performance like musicians, banned from the olympics
Mildly unpleasant to take gives you nightmares, distant feeling and you become exhausted more quickly
Not a sedative at all

Question 10

Finally describe SSRIs as a drug class for anxiety

Answer 10

Fluoxetine/ Prozac
Discovered In the 1970s but first went on say 15 years later
Marketed as an anti-d but main drug used for anxiety
Main effect is “serenic “ so you feel stable, blunted emotions
Not addictive because they’re not pleasant to take, not sedative either
Unemotionality and first few days of nausea, also produces dependence so you can’t just stop without symptoms returning or going through withdrawal.
Also correlates with mass shootings and suicide by hanging. Inner turmoil

Question 11

Which is the most common psychiatric symptom?

Answer 11

Anxiety