Anti anxiety
Anti anxiety drugs
Classification of antianxiety drugs
Adverse effects
Anti anxiety medications
Anti anxiety treatment
Classification
,
Pharmacology
Anti anxiety drugs
Classification of antianxiety drugs
Adverse effects
Anti anxiety medications
Anti anxiety treatment
You will learn in this article above mentioned topics.
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ANTI ANXIETY
Anxiety : It is an emotional state, unpleasant in nature, associated with uneasiness, discomfort and concern or fear about some defined or undefined future threat.
Some degree of anxiety is a part of normal life.
Treatment is needed when it is disproportionate to the situation and excessive.
Anti anxiety drugs
These are an ill-defined group of drugs, these are mostly mild CNS depressants which are aimed to control the symptoms of anxiety.
Drug produce a restful state of mind without interfering with normal mental or physical functions.
The anxiolytic-sedative drugs differ markedly from antipsychotics and more closely resemble sedative-hypnotics.
CLASSIFICATION
1. Benzodiazepines : Diazepam, Chlorodiazepoxide, Oxazepam, Lorazepam, Alprazolam.
2. Azapirones : Buspirone, Gepirone, Ispapirone.
3. Sedative antihistaminic : Hydroxyzine.
4. beta blocker : Propranolol.
ANTI ANXIETY MEDICATIONS
The most commonly used drugs are :
Benzodiazepines - Diazepam, Chlorodiazepoxide, Oxazepam, Lorazepam, Alprazolam.
Some drugs if Benzodiazepines have a slow and prolonged action, relieve anxiety at low doses without producing global CNS depression.
They have a selective taming effect on aggressive animals and suppress induced aggression.
They also suppress the performance impairing effect of punishment.
They are more selective for limbic system and have proven clinically better in both quality and quantity of improvement in anxiety and stress related symptoms.
They act primarily by facilitating inhibitory GABAergic transmission, but other additional mechanisms of action have been suggested.
Higher doses induce sleep and impair performance.
1. Chlordiazepoxide :
It was the first BZD to be used clinically.
Oral absorption is slow.
Produces smooth long lasting effect.
Preferred in chronic anxiety states.
Its t1/2 is 5-12 hours but active metabolites are produced which extend the duration of action. It has poor anticonvulsant action.
2. Diazepam :
Quickly absorbed.
Produces a brief initial phase of strong action followed by prolonged milder effect due to a two phase plasma concentration decay curve (distributive phase t1/2 1 hr, elimination phase t1/2 20-30 hours).
Preferred in acute panic states and anxiety associated with organic disease.
3. Oxazepam :
Slowly absorbed.
Penetration in brain is also slow.
Plasma t1/2 is about 10 hrs.
Duration of action is relatively shorter.
Preferred in the elderly and in those with liver disease.
Mainly used in short lasting anxiety states.
4. Lorazepam :
Has slow oral absorption.
Its rate of entry in brain is slower.
t1/2 (10-20 hrs).
Preferred for shortlived anxiety states, tension syndromes etc.
5. Alprazolam :
Particularly useful in anxiety associated with depression.
Good response has been obtained in panic disorders with severe anxiety and autonomic symptoms.
t1/2 is about 12 hrs.
Cause less drowsiness.
6. Buspirone :
It is the first azapirone, a new class of antianxiety drugs, distinctly different from BZDs.
Relieves mild to moderate generalized anxiety, but is ineffective in severe cases, in those showing panic reaction and in OCD.
Buspirone is rapidly absorbed.
Undergoes extensive first pass metabolism.
Bioavailability <5% .
Excretion occurs both in urine and faeces.
t1/2 is 2 - 3.5 hrs.
Adverse effects of Benzodiazepines
Sedation
Lightheadedness
Psychomotor
Cognitive impairment
Vertigo
Confusional state
Increased appetite
Weight gain
Alterations in sexual function
Rashes
Adverse effects of Buspirone
Dizziness
Nausea
Headache
Light headedness
Excitement
Rise in BP
ANTI ANXIETY TREATMENT
If anxiety symptoms are frequent and persist in a severe form, they are a cause of distress and markedly impair performance.
It should be treated with drugs only when excessive and disabling in its own right.
Drug should be used in the smallest possible dose. The dose has to be found out for each patient by titration with symptoms of anxiety.
The drug should be withdrawn as soon as it is no longer required. But when large dose have been used for longer periods, withdrawal should be gradual.
The usual practice is to give 1/2 to 2/3 of the daily dose at bed time to ensure good nightly rest; the remaining is divided in 2-3 doses given at day time.
Buspirone is a nonsedating alternative to BZDs for less severe forms of generalized anxiety.
The tricyclic and SSRI anti depressants are now being increasingly used in many forms of severe anxiety.
They produce a delayed but often gratifying response and can be combined with BZDs. The SSRIs are now drugs of choice for social anxiety in which BZDs though effective, carry abuse potential on long term use.
Patient with hypertension, peptic ulcer, ulcerative colitis, irritable bowel, gastroesophageal reflux, thyrotoxicosis, angina pectoris, are often given low dose of BZD in addition to specific therapy, though anxiety may not be prominent manifestation.
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It should be treated with drugs only when excessive and disabling in its own right.
Drug should be used in the smallest possible dose. The dose has to be found out for each patient by titration with symptoms of anxiety.
The drug should be withdrawn as soon as it is no longer required. But when large dose have been used for longer periods, withdrawal should be gradual.
The usual practice is to give 1/2 to 2/3 of the daily dose at bed time to ensure good nightly rest; the remaining is divided in 2-3 doses given at day time.
Buspirone is a nonsedating alternative to BZDs for less severe forms of generalized anxiety.
The tricyclic and SSRI anti depressants are now being increasingly used in many forms of severe anxiety.
They produce a delayed but often gratifying response and can be combined with BZDs. The SSRIs are now drugs of choice for social anxiety in which BZDs though effective, carry abuse potential on long term use.
Patient with hypertension, peptic ulcer, ulcerative colitis, irritable bowel, gastroesophageal reflux, thyrotoxicosis, angina pectoris, are often given low dose of BZD in addition to specific therapy, though anxiety may not be prominent manifestation.
😊 I hope you've got help, if you have any suggestion or any question regarding this article "Anti anxiety | anti anxiety medications,, please comment i will be very happy.
Thanks
