Anxiety Medications PDF

Anxiety Medications Key Neurotransmitters in Anxiety GABA (Gamma-Aminobutyric Acid) Serotonin (5-HT) Norepinephrine (NE) Glutamate Benzodiazepines Mechanism of Action: Effects: Clinical Applications-Fast-Onset Benzodiazepines (15-30 minutes) *These are used when rapid relief is nee...

Anxiety Medications Key Neurotransmitters in Anxiety GABA (Gamma-Aminobutyric Acid) Serotonin (5-HT) Norepinephrine (NE) Glutamate Benzodiazepines Mechanism of Action: Effects: Clinical Applications-Fast-Onset Benzodiazepines (15-30 minutes) *These are used when rapid relief is needed, especially in acute situations where immediate control of anxiety, panic, or other symptoms is critical. Panic Attacks: Alprazolam (Xanax) and Diazepam (Valium) : Diazepam : Acute Anxiety Episodes: Alprazolam: Diazepam : Intermediate-Onset Benzodiazepines (30-60 minutes) *These are used when moderate speed of relief is needed, balancing rapid effects with a slightly longer duration of action. They are preferred for sustained symptom control without the intense peaks and troughs associated with very fast-onset drugs Clinical Applications 1. Generalized Anxiety Disorder (GAD): Lorazepam (Ativan) and Clonazepam (Klonopin) : Clonazepam: 2. Short-term Management of Anxiety: Lorazepam: Intermediate-Onset Benzodiazepines (30-60 minutes) 3. Acute Mania or Agitation: Lorazepam 4. Seizure Disorders: Clonazepam 5. Insomnia (Short-term): Temazepam (Restoril): Slow-Onset Benzodiazepines (1- 2 hours) These are primarily used in situations where gradual relief is acceptable or even preferred. Their slower onset makes them less likely to be abused for the immediate euphoric effects, so they are useful in more controlled, chronic situations. Clinical Applications: 1. Chronic Anxiety Disorders: Oxazepam (Serax) and Chlordiazepoxide (Librium) are used for chronic anxiety, particularly Selective Serotonin Reuptake Inhibitors (SSRIs) Mechanism of Action: Effects: Common Drugs: Sertraline (Zoloft) Paroxetine (Paxil) Escitalopram (Lexapro) Fluoxetine (Prozac) Indications: Considerations: Initial side effects may include increased anxiety, insomnia, nausea, and sexual dysfunction. SSRIs are generally well-tolerated for long-term use and have a lower risk of dependence compared to benzodiazepines. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) Mechanism of Action: Effects: Common Drugs: Venlafaxine (Effexor) Duloxetine (Cymbalta) indications: Considerations: Common side effects include increased blood pressure (especially with venlafaxine), insomnia, and nausea. Buspirone (Buspar) Mechanism of Action: Effects: Indications: Considerations: Buspirone takes 2–4 weeks to achieve full efficacy. It is generally well-tolerated, but may cause dizziness, headaches, and n Beta-Blockers (e.g., Propranolol) Mechanism of Action: Effects: Common Drugs: Propranolol (Inderal) Indications: Considerations: Antihistamines Mechanism of Action: Common Drugs: Hydroxyzine (Vistaril, Atarax) Indications: Considerations: Atypical Antipsychotics (e.g., Quetiapine) Mechanism of Action: Common Drugs: Quetiapine (Seroquel) Indications: Considerations: Side effects include sedation, weight gain, and metabolic syndrome risks. Reserved for patients who do not respond to first-line treatments. Gabapentinoids Mechanism of Action: Common Drugs: Gabapentin (Neurontin) Pregabalin (Lyrica) Indications: Considerations: Considerations for Prescribing Anxiolytics Short-term vs. Long-term Treatment: Benzodiazepines are effective for acute anxiety but are generally avoided for long-term use due to the risk of tolerance and dependence. SSRIs, SNRIs, and buspirone are better suited for long-term management. Comorbid Conditions: Many patients with anxiety also experience depression, and SSRIs/SNRIs are beneficial for both conditions. Side Effects and Safety: Monitoring for side effects such as sedation (especially with benzodiazepines and antipsychotics), weight gain (with antipsychotics), and cardiovascular effects (with beta-blockers and SNRIs) is essential.