Week 13: Anxiolytics and Hypnotics

Question 1

for panic disorder, what meds are good?

Answer 1

ssri’s (fluxoetine, paroxetine, sertraline) and clomipramine (Anafranil) work better than benzos bc benzos are addicting

can add in buspirone (buspar) (not mono)

Question 2

OCD treatment

Answer 2

SSRI or clomipramine, and non pharm intervention as adjunct

Question 3

whats most effective for OCD treatment?

Answer 3

combo med + cognitive behavior therapy

Question 4

PTSD first line tx

Answer 4

sertaline (zoloft) and paroxetine (paxil)

Question 5

what class of meds reduce sx’s from all PTSD sx’s clusters (re-experiencing, avoidance, hyperarousal)?

Answer 5

ssri/snri’s

and buspirone

Question 6

what med is good for ptsd nightmares?

Answer 6

prazosin (minipress)

blocks the adrenaline and noradrenergic stimulation of alpha 1 receptor that can cause nightmares

Question 7

what are the z compound medications and MOA

Answer 7

zolpidem (ambien), eszopiclone (lunesta)

act as agonist on the benzodiazepine site of the GABA receptor

tolerance and dependence not common
Lunesta - approved for long term use

Question 8

buspirone (Buspar) class and MOA

Answer 8

anxiolytic med similar to benzo

MOA: act as partial agonist for serotonin 5 HT1a receptors in brain

no dependence, less sedation, no CNS depression with alc

slow onset (1-2 weeks)

Question 9

barbiturates (phenobarbital) c/c

Answer 9

high abuse potential and addiction

bad SE (resp depression)

narrow TI

Question 10

clonidine off label for

Answer 10

its an antihypertensive

PTSD, social anxiety, tourettes, w/drawal, menopausal flushing, severe pain in cancer pts

Question 11

propranolol off label for

Answer 11

beta blocker

PTSD, GAD, violence/aggressive

if used asap after trauma, can prevent PTSD