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Antianxiety Drugs

Benzodiazepines
Examples: Short-Acting (2-5 hr. half life) – Triazolam(Halcion)
Intermediate-Acting ( ~5 – 20 hr. half life) – Xanax, Paxipam, Ativan, Serax, Restoril
Long-Acting (up to 150 hr. half life) – Clordiazepoxide, Klonopin, Tranxene, Valium,
Dalmane, Centrax, Doral
Routes of Administration: PO
Action: Benzodiazepines enhance the effects of the inhibitory neurotransmitter
GABA. GABA attaches GABA receptors, which trigger the opening of chloride
channels. Chloride has a hyperpolarizing effect on the neuron, which makes the
neuron less responsive to excitatory neurons. The overall effect is one of slowing
down of halting neuronal firing.
Side Effects: CNS- drowsiness, fatigue, and decreased coordination, slowing of
reflexes, confusion, depression, and headaches
PNS- constipation, double vision, hypotension, incontinence, and urinary retention.
Assessment: Contraindicated for patients with hypersensitivity and narrow-angle
glaucoma, monitor BP, P, and R. Signs and symptoms of overdose include
somnolence, confusion, coma, diminished reflexes, and hypotension.
Labs: CBC (long term), serum creatinine
Education: Alcohol, opiods, antipsychotics, and antihistamines, increase the
sedative effects, high potential for abuse, not intended for everyday stressors, over-
the-counter drugs may enhance the actions, driving should be avoided until
tolerance develops, these drugs should not be stopped abruptly, and use relaxation
techniques

Nonbenzodiazepine: Buspirone “first line agent for anxiety”


Advantages: NOT sedating, low potential for abuse, no cross-tolerance with
sedatives or alcohol, no dependence, withdrawal or tolerance
Examples: BuSpar
Routes of Administration: PO
Action: Agonist at the pre synaptic serotonin 1A receptor.
Side Effects: dizziness, nausea, headache, nervousness, light-headedness,
insomnia, problem concentrating, and excitement
Assessment: assess degree and manifestations of anxiety before and periodically
during therapy. Buspirone does not appear to cause dependence but assess for
tolerance with patients with previous dependence. Restrict amount of drug available
to these patients.
Labs: LFT (extensively metabolized by the liver)
Education: Delayed effect (1 to 6 weeks), take with food to increase therapeutic
effects, avoid grapefruit juice, and if taking benzodiazepines must be tapered off
while buspirone is initiated

Selective Serotonin Reuptake Inhibitors (see antidepressant medications)


Used with : Long term treatment for panic attacks, OCD, PSTD, GAD
Other Drugs with Antianxiety Properties:
-Clomipramine (SRI)- most effective in OCD.
Side effects: HA, reduced libido, nervousness, myoclonus, and increase apetite, dry
mouth constipation
-Clonidine (alpha-2 agonist) – anti anxiety effects, indicated for hypertension, this
drug decreases neurotransmitter production
-Propranalol (beta blocker) interrupts the physiologic response of anxiety related to
social phobia. Less risk for abuse than the benzo’s. Side effects include:
lightheadedness, and heart block

*All information was found starting on page 265 in Psychiatric Nursing under
“Antianxiety Drugs.”