Pharmacology Of Anxiolytic Drugs Flashcards
What Drugs used to treat anxiety?
Barbiturates ( NOT RECOMMENDED) Benzodiazepines Antidepressants Buspirone Pregabalin Beta blockers
Examples of benzodiazepines
Midazolam (hypnovel) Lorazepam (Ativan) Loprazolam Alprazolam (Xanax) Nitrazepam Diazepam (Valium) Chlodiazepoxide Flurazepam Clonazepam
Action of benzodiazepines?
Increase GABA-mediated inhibition
Enhance activation of GABA at the GABAa receptor
Pharmacological effects of benzodiazepines?
Decrease anxiety and depression Hypnosis/ sedation Muscle relaxation Anticonvulsant effect Anterograde amnesia
What does GABA stand for?
Gamma amino butyric acid
Clinical uses of benzodiazepines?
Acute treatment of extreme anxiety Hypnosis Alcohol withdrawal Mania Delirium Rapid tranquilisation Pre medication before surgery Status epilepticus
Problems with benzodiazepines
Paradoxical aggression
Anterograde amnesia and impaired coordination
Tolerance and dependence - rebound anxiety on withdrawal
What is neuroadaptation of GABA response in benzodiazepine use?
Chronic treatment causes decreased response to GABA
Withdrawal and lead to anxiety and convulsions possible due to decreased density of BZ receptors
How do you withdraw from benzodiazepines?
Transfer to equiv. does of diazepam - take at night
Reduce dose every 2-3 weeks by 2-2.5 mg
Keep reducing slowly
Stop
When are SSRIs used in anxiety?
Panic disorder OCD PTSD phobias GAD
What SSRIs are used for GAD?
Escitalopram
Paroxetine
When are tricyclics used in anxiety?
2nd line for panic disorder and OCD
What tricyclics are used in anxiety?
Clomipramine
Imipramine
What is ventafaxine used for?
GAD
What is moclobemide used for?
Social anxiety disorder
