In our previous post we have already talked about types of anxiety and basic understanding,so here we will be talking about the drugs used in anxiety i.e anxiolytic drugs.
Anxiolytic Drugs-
A) Benzodiazepines (BZD)-
BZDs are sometime knows as benzos, there chemical structure is a fusion of benzene ring and a diazepine ring.
BZDs are used in conditions like anxiety,insomnia,seizures.
They have anxiolytic as well as sedative action
They acts be increasing GABA activity to normal
They have immediate action
BZDs may cause severe problems if they are taken with opioids or with alcohol.
A/E-
If BZDs are used inhigh dosage they it may cause some adverse effects like drowsiness,oversedation,amnesia,ataxia and so these patient’s have high risk of road accidents.
So to prevent such adverse effects half of the adult dose should be used in elderly aged people and also we should not use BZDs for long time.
It includes drugs like-
•Diazepam
•Acebutazolam
•Lorazepam
•Clonazepam
•Alprazolam
•Fluzepam
•Oxazepam
•Nitrazepam
•Metazolam
•Chlordiazepoxide
We will be talking more about specific drugs of this group in our upcoming post.
B) Azapirones-
They acts by decreasing 5HT activity
They have only anxiolytic action,causes no sedation
No immediate action as of BZDs,it takes 1 to 2 weeks to show its effect.
Azapirones are used in general Anxiety disorders (GAD),they are commonly used as add-ons to other antidepressants,such as selective serotonin reuptake inhibitors.
It includes drug like-
•Buspirone– It acts on pre synaptic neuron from where 5HT is released and decreases the release of 5HT.Buspirone is taken orally.One thing to keep in mind about Buspirone is about its interaction with other drugs.When patient is taking antibiotics along with Buspirone then it may cause increase in levels of buspirone in body so we will decrease the dosage of buspirone in the patient who is already taking any antibiotics.
Same may also occur when patient is on anti fungal medications
A/E– Dizziness,nausea,headache
•Tandospirone– Used in anxiety, psychosis (as adjuvent),in alcohol degeneration disease,in bruxism.
Bruxism– A condition in which patient clinch or grind his teeth when awake (awake bruxism) or during sleep (sleep bruxism).
Patients with sleep bruxism are more likely to have other sleep disorders like sleep apnea,snoring etc.
•Ispapirone
•Gepirone– It is found that gepirone may also improve symptoms of sexual dysfunctions in men and women.
C) Anti Histaminic Drugs-
They decreases histamine activity.
They have anxiolytic as well as sedative action
They also have immediate action as of BZDs
•Hydroxyzine– It is the most commonly prescribed anti Histaminic drug for anxiety,it is used most often in GAD.It is also used in itching,nausea complains.
It is to be noted that hydroxyzine should not be given in first trimester of pregnancy.Also it is said that patient should not drive car or should not even operate any machinery work because it may cause dizziness in the patient which may lead to some accident during driving or operating work.
Also it is not be used by breast feeding mothers because it passes in breast milk and may cause harm to the child.
Common side effects-
Dizziness,fatigue,drowsiness
Xerostomia (dry mouth)
Headache,confusion etc.
Contributor- Medico Anant Singh Nanda