Antianxiety Drugs

Benzodiazepines

• increased intracellular influx of Cl-

• amnesia

• controlled substance schedual IV

• Sedative, anticonvulsant, muscle relaxant, hypnotic, No antichol effects

• Binds GABA receptor- leading to Cl- influx and neuron stabalization ( may effect 5-HT)

• Rebound insomnia

• Prod. Paranoid behavior

• Daytime Hangover (greatest with shortest acting drugs)

• Low toxicity, effects of alchohol and other drugs may be reinforced

Benzodiazepines

Diazepam (valium)

• I.V sedation and amnesia dose is 2-20 mg

• Indicated for antianxiety and muscle relaxation

• Approved for tx for nocturnal bruxism

• Long acting 20-50 hr T1/2

Triazolam

• Shotest T1/2 (theraputic effect 3-4 hrs)

• Increased dose causes increased memory lose and amnesia

• Strongest rebound insomnia

Midazolam

• I.V dose for pre-op 1-1.5 milligrams

• Indications: amnesia, sedation, anti-anxiety

• More potent than diazepam

• Must lower narcotic doses to prevent respiratory depression

Lorazepam

• Low water solubility

• Short acting T1/2 = 10-18 hrs

• Drug of choice for status epilepticus (diazepam also a standard)

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• contraindicated in narrow angle glaucoma

Buspirone (benzodiazepine deriv.)

(structurally similar to Halperidol)

• Anxiolytic without sedation!

• Partian 5HT1a agonist

• Preferred for long term anxiety tx

• Short T1/2

• No anticholinergic effect

Flumazenil

• Competitively aBlocks benzodiazepine-GABA receptor site

  • Used as an antidote