Drugs for Anxiety Disorders

What type of anxiety medications are SSRIs and SNRIs?

antidepressants

Are benzodiazepines used for short-term or long-term use?

short-term

Why are benzodiazepines used only for short-term anxiety?

they have a high risk of addiction

How do benzodiazepines affect the CNS?

they’re a depressant

What should you avoid when on benzodiazepines?

alcohol + other CNS depressants

What are some common side effects of benzodiazepines?

hypnosis, lightheadedness, ataxia (loss of coordination), decreased cognitive function, + lethargy (in general, it slows down the body + brain)

What two population groups should be cautious when using benzodiazepines?

pregnant women + older adults

TRUE or FALSE: you must avoid quitting benzodiazepines cold-turkey.

true; they can cause withdrawal effects when used in high amounts

What are some withdrawal effects of benzodiazepines?

anxiety, insomnia, tremors, + seizures

What is the prototype drug for atypical anxiolytics?

buspirone

TRUE or FALSE: buspirone is a sedative.

false

What is an anxiolytic?

anti-anxiety medication

What type of drug is buspirone?

atypical anxiolytic

TRUE or FALSE: buspirone has less potential for abuse.

true

Why are atypical anxiolytics usually taken as a first-resort?

they are less addictive

What patient education should you give when discussing atypical anxiolytics?

it takes one week for an initial effect and four weeks for the full effect (so don’t stop taking them early!)

What are some side effects of atypical anxiolytics + buspirone?

dizziness, nausea, + agitation

What should you avoid when taking atypical anxiolytics?

grapefruit juice + st. john’s wort (+ erythromycin)

What can taking st. john’s wort or grapefruit juice with buspirone lead to?

serotonin syndrome

How are antihistamines used to help anxiety?

they help relieve anxiety, panic attacks, and insomnia

What are some common side effects of antihistamines?

dry mouth, constipation, sedation, + risks of use while driving

Which patient populations should be cautious when taking antihistamines?

the elderly + pts with neurocognitive disorders

What is the primary issue with antihistamines?

tolerance development

What is an example of an antihistamine?

hydroxyzine

How are beta blockers used to help with anxiety?

they decrease physical symptoms by blocking stress hormones (and also help prevent traumatic memories + nightmares)

What is an example of a beta blocker?

propanolol

What is the suffix for benzodiazepines?

-z…pam, -z…lam

Are benzos usually taken short-term or long-term?

short-term due to risk of addiction

How long should benzos be taken for?

max of 6 weeks

What is a side effect caused by long-term use of benzodiazepines?

memory loss

What is a side effect caused by taking benzodiazepines and other CNS depressants?

additive sedation (can be fatal)

Which category of restricted drugs are benzos?

schedule IV

Can children take benzodiazepines?

yes but give the lowest effective dose due to the risk of a paradoxical reaction (opposite of intended effect)

What changes when giving benzodiazepines to the elderly?

the drug is metabolized more slowly, creating a longer half-life

TRUE or FALSE: benzodiazepines are CNS depressants.

true

TRUE or FALSE: benzodiazepines can cause withdrawal symptoms.

true

How long does buspirone take to work?

1 week for initial response + 4 weeks for full effect

TRUE or FALSE: antidepressants are used short-term for anxiety and OCD.

false; they’re used long-term

How long does it take for antidepressants to help w/ anxiety

2-4 weeks

Which antidepressant SSRI is typically used for long-term anxiety treatment?

escitalopram

Which SNRI might be used for anxiety treatment?

duloxetine

What are beta blockers used for in anxiety?

physical symptoms of anxiety + nightmares from PTSD

What are anticonvulsants used for in anxiety?

mood stabilizers