Anxiety RevisePharma PDF

Anxiety RevisePharma Treatment Acute – benzos Chronic – SSRI (sertraline, citalopram, escitalopram, fluoxetine), Propranolol alleviates physical symptoms only Benzodiazepines o Can induce hepatic coma, especially long-acting benzos o Long-acting benzos = diazepam, alpr...

Anxiety RevisePharma Treatment Acute – benzos Chronic – SSRI (sertraline, citalopram, escitalopram, fluoxetine), Propranolol alleviates physical symptoms only Benzodiazepines o Can induce hepatic coma, especially long-acting benzos o Long-acting benzos = diazepam, alprazolam, chlordiazepoxide hydrochloride, clobazam o Short-acting benzos – lorazepam and oxazepam. Short-acting preferred in patients with hepatic impairment and elderly. Greater risk of withdrawal symps (use for 2-4 weeks). o Can cause paradoxical effects – aggression, hostility, talkative, excited etc. o Sedation increased with use of Alcohol, CNS depressants or CYP Enzyme Inhibitors – avoided with concomitant use. o Avoid if feeling drowsy (benzos with a legal driving limit – Clonazepam, Oxazepam, Lorazepam, Diazepam, Flunitrazepam and Temazepam (COLD FT)) o Overdose treated with flumazenil Benzodiazepines Withdrawal Dependence – anxiety, sweating, weight loss, tremors, loss of appetite 1) Convert all meds to once nightly dose of diazepam 2) Reduce by 1-2mg (1/10th on larger doses) every 2-4 weeks. (only withdraw further if patient has overcome any withdrawal symptoms) 3) Reduce further (0.5mg near the end)