Comprehensive Guide to Anxiety and Mood Disorder Medications: Benzodiazepines, SSRIs, MAOIs, and More

Anxiolytics

Drugs used to treat anxiety disorders; also called tranquilizers

Benzodiazepines drug class

Anxiolytics that enhance GABA activity

Examples of benzodiazepines

Xanax, Librium, Tranxene, Valium, Ativan, Serax

Benzodiazepine uses

Anti-anxiety, sedative, hypnotic, muscle relaxant, anticonvulsant, alcohol withdrawal

Benzodiazepine withdrawal

Rapid withdrawal causes alcohol-like withdrawal; taper dose gradually

Benzodiazepines controlled status

Schedule IV controlled substance

GABA role

Inhibitory neurotransmitter controlling emotions in limbic system

Benzodiazepine mechanism

Enhance GABA without causing CNS depression

Benzodiazepine contraindications

Narrow-angle glaucoma, alcohol use

Diazepam dosage

2-10 mg BID-TID for mild to moderate anxiety

Benzodiazepine premed assessment

Check hepatic function

Benzodiazepines without active metabolites

Lorazepam and oxazepam

Azaspirones drug class

Non-benzodiazepine anxiolytics

Buspirone mechanism

Does not affect GABA receptors

Buspirone advantages

Low sedation, no psychomotor impairment

Buspirone indication

Short-term relief of anxiety

Buspirone onset

7-10 days

Buspirone abuse potential

Minimal

Buspirone controlled status

Not a controlled substance

SSRIs for anxiety

Used for OCD and panic disorders

Fluvoxamine use

OCD treatment

SSRI mechanism

Inhibits serotonin reuptake

SSRI therapeutic outcome

Reduced anxiety and compulsive behaviors

Hydroxyzine drug class

Miscellaneous antianxiety agent

Hydroxyzine actions

Sedative, antiemetic, anticholinergic, antihistaminic, antianxiety, antispasmodic

Hydroxyzine uses

Pre/post-op sedation, vomiting control, antipruritic

Antidepressants purpose

Elevate mood and reduce depression

MAOI mechanism

Block monoamine oxidase, increasing neurotransmitters

Neurotransmitters affected by MAOIs

Epinephrine, norepinephrine, dopamine, serotonin

MAOI indications

Atypical depression, panic disorder, OCD, phobias

MAOI examples

Nardil, Parnate, Marplan

MAOI dietary restriction

Avoid tyramine-containing foods

MAOI hypertensive crisis symptoms

Occipital headache, stiff neck, sweating, nausea, vomiting, high BP

MAOI nursing teaching

Orthostatic hypotension precautions

SSRIs antidepressant class

Most widely used antidepressants

SSRI advantages

Fewer side effects

SSRI onset of action

2-4 weeks

SSRI examples

Prozac, Paxil, Luvox, Celexa, Zoloft, Lexapro

SSRI administration tip

Take at bedtime if sedating

SSRI additional uses

OCD and panic disorders

SNRIs mechanism

Inhibit serotonin and norepinephrine reuptake

SNRI examples

Pristiq, Cymbalta, Effexor

Tricyclic antidepressants mechanism

Block reuptake of NE, dopamine, serotonin

TCA onset of action

2-4 weeks

TCA therapeutic effects

Elevated mood, improved appetite, increased alertness

Amitriptyline side effects

Hypotension, dry mouth, constipation, urinary retention

Examples of TCAs

Elavil, Anafranil, Norpramin, Sinequan, Tofranil, Pamelor, Aventyl, Vivactil, Surmontil

Bupropion use

Depression and smoking cessation

Mirtazapine action

Similar to tricyclic antidepressants

Antimanic agents drug class

Mood stabilizers

Lithium indication

Drug of choice for bipolar mania

Lithium mechanism

Competes with electrolytes; replaces sodium

Lithium uses

Acute mania and bipolar prophylaxis

Therapeutic lithium level

0.4-1.2 mEq/L

Lithium toxicity level

Above 1.2 mEq/L

Lithium toxicity early signs

Nausea, vomiting, diarrhea, tremor, lethargy

Lithium nephrotoxicity

Monitor urine output

Lithium sodium interaction

Low sodium increases toxicity

Lithium client teaching

Maintain fluids and normal sodium intake

Neuroleptic agents

Major tranquilizers

Antipsychotic mechanism

Block dopamine receptors

Atypical antipsychotic mechanism

Block dopamine and serotonin

Typical antipsychotics examples

Chlorpromazine, Thiothixene, Haloperidol, Fluphenazine

Atypical antipsychotics examples

Abilify, Zyprexa, Seroquel, Risperdal, Geodon, Clozaril

Antipsychotic effectiveness

Improves thought processes

Antipsychotic onset

Several weeks

Common antipsychotic issue

Noncompliance

Antipsychotic client teaching

Continue medication even if symptoms improve

Antipsychotic side effects

EPS, sedation, metabolic effects

Antipsychotic interaction

Increased CNS depression with alcohol

Clozapine indication

Treatment-resistant schizophrenia

Clozapine risks

Agranulocytosis, seizures

Clozapine monitoring

Weekly WBC with differential

Extrapyramidal symptoms

Motor side effects of antipsychotics

Dystonia symptoms

Muscle spasms of face, neck, tongue

Dystonia treatment

Benadryl, Cogentin, Artane

Akathisia symptoms

Motor restlessness

Akathisia treatment

Anticholinergics, benzodiazepines

Pseudoparkinsonism symptoms

Tremor, rigidity, shuffling gait

Pseudoparkinsonism treatment

Benztropine, diphenhydramine

Tardive dyskinesia symptoms

Lip smacking, tongue movements

Tardive dyskinesia management

Early detection and drug withdrawal

Neuroleptic malignant syndrome cause

Dopamine blockade

NMS symptoms

Hyperthermia, rigidity, altered consciousness

NMS treatment

Stop antipsychotic and treat symptoms

ADHD stimulant examples

Ritalin, Adderall, Dexedrine

ADHD stimulant effects

Improve concentration

ADHD stimulant side effects

Insomnia, anorexia

Extended-release ADHD meds

Ritalin SR, Adderall SR, Concerta, Metadate ER

Strattera drug class

Non-stimulant ADHD medication

Strattera mechanism

Norepinephrine reuptake inhibition

Substance abuse definition

Using a substance to live and living to use

Categories of abused substances

Stimulants, depressants, narcotics, cannabis, hallucinogens, inhalants

Common abused opioids

Heroin, morphine, oxycodone, hydrocodone

Synthetic opioids

Fentanyl, meperidine

Naltrexone mechanism

Opioid antagonist

Naltrexone use

Reduce alcohol and opioid cravings

Buprenorphine classification

Partial opioid agonist

Buprenorphine advantage

Ceiling effect on respiratory depression

Buprenorphine forms

Subutex and Suboxone