Major types of anxiety disorders
generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD)
Drugs that can cause anxiety
albuterol, antipsychotics, bupropion, caffeine, decongestants, illicit drugs, levothyroxine, steroids, stimulants, theophylline
Natural products to help with anxiety
St. Johns wort, Kava, Valerian, Passionflower
St. John's wort is a strong CYP3A4 inducer and can
decrease the concentration of other medications
Kava is a relaxant, but it can cause severe
liver damage and it not recommended
First-line treatment for anxiety
SSRIs and SNRIs
Second-line treatment for anxiety
buspirone, TCAs, hydroxyzine, pregabalin, gabapentin, propranolol
Brand name for hydroxyzine
Vistaril
MOA of buspirone
effects may be due to its affinity for 5-HT1A and 5-HT2 receptors
BZDs enhance GABA, an
inhibitory neurotransmitter
Due to the risk of dependence, BZDs should only be used for
1-2 weeks and then discontinued
Which BZDs are preferred in elderly and liver impairment
lorazepam, oxazepam, temazepam (LOT)
(because they under glucuronidation)
All BZDs are
C-IV
Antidote for BZDs
flumazenil
Which BZDs is lipophilic, fast onset, long half-life, high abuse potential
diazepam
Brand name diazepam
Valium
Which BZDs has fast onset and often abused due to its quick action
alprazolam
Brand name for alprazolam
Xanax
Brand name for clonazepam
Klonopin
BZDs commonly used for alcohol withdrawal
lorazepam, diazepam, chlordiazepoxide
Brand name for clorazepate
Tranxene