Anti-Anxiolytics, Sedative-Hypnotics, and Stimulants

Buspirone

Brands = Buspar

Drug Class = Anti-anxiolytic

Typical use = General anxiety

Benzodiazepines

CS Schedule =C-IV

Clonazepam

Brands = Klonopin

Drug Class = Benzodiazepine

Typical use = Anxiety

CS Schedule = C-IV

Alprazolam

Brands = Xanax

Drug Class = Benzodiazepine

Typical use = Anxiety

CS Schedule = C-IV

Diazepam

Brands = Valium

Drug Class = Benzodiazepine

Typical use = Anxiety, seizures

CS Schedule = C-IV

Lorazepam

Brands = Ativan

Drug Class = Benzodiazepine

Typical use = Anxiety, status-ep

CS Schedule = C-IV

Chlordiazepoxide

Brands = Librium

Drug Class = Benzodiazepine

Typical use = Anxiety, alcohol withdrawal

CS Schedule = C-IV

Midazolam

Brands = Versed

Drug Class = Benzodiazepine

Typical use = Procedural sedation

CS Schedule = C-IV

Eszopiclone

Brands = Lunesta

Drug Class = Non-BZD hypnotic

Typical use = Insomnia

CS Schedule = C-IV

Zolpidem

Brands = Ambien

Drug Class = Non-BZD hypnotic

Typical use = Insomnia

CS Schedule = C-IV

Zaleplon

Brands = Sonata

Drug Class = Non-BZD hypnotic

Typical use = Insomnia

CS Schedule = C-IV

Amphetamine/dextro-

Brands = Adderall

Drug Class = Mixed amphetamine salts

Typical use = ADHD

CS Schedule = C-II

Dexmethylphenidate

Brands = Focalin

Drug Class = Methylphenidate analog

Typical use = ADHD

CS Schedule = C-II

Methylphenidate

Brands = Ritalin, Concerta, Daytrana

Drug Class = CNS stimulant

Typical use = ADHD

CS Schedule = C-II

Lisdexamfetamine

Brands = Vyvanse

Drug Class = Pro-drug amphetamine

Typical use = ADHD

CS Schedule = C-II

Atomoxetine

Brands = Strattera

Drug Class = Selective NRI

Typical use = ADHD

Mechanism / Therapeutic Rationale

• BZD: CNS depression (anxiolysis, sedation, anticonvulsant).

• “Z-drugs:” Sleep onset/maintenance.

• Buspirone: Partial serotonin agonist → anxiolysis without sedation.

• Stimulants: Block NE/DA reuptake & promote release → ↑ prefrontal cortex focus.

• Atomoxetine: Selective NE reuptake inhibitor → ↑ attention, ↓ hyperactivity.

Hallmark Common SEs

✓ BZD/“Z” → drowsiness, cognitive slowing

✓ Stimulants → insomnia, ↓ appetite, weight loss

✓ Buspirone → dizziness/HA

Serious / Boxed Risks

BZD: respiratory depression, dependence, withdrawal

“Z-drugs:” complex sleep behaviors (sleep-drive/walk → injury/death)

Stimulants: abuse/misuse, sudden CV death, HTN

Atomoxetine: suicidal ideation in pediatrics/adolescents

High-Yield Interactions & Contra-Indications

• MAOIs within 14 days: serotonin or hypertensive crisis (buspirone, stimulants, atomoxetine)

• CNS depressants/opioids/alcohol ↑ respiratory/CNS depression (BZD, “Z-drugs”)

• Severe cardiac disease/mod-severe HTN: avoid most stimulants & atomoxetine