Major types of anxiety disorders

generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD)

Drugs that can cause anxiety

albuterol, antipsychotics, bupropion, caffeine, decongestants, illicit drugs, levothyroxine, steroids, stimulants, theophylline

Natural products to help with anxiety

St. Johns wort, Kava, Valerian, Passionflower

St. John's wort is a strong CYP3A4 inducer and can

decrease the concentration of other medications

Kava is a relaxant, but it can cause severe

liver damage and it not recommended

First-line treatment for anxiety

SSRIs and SNRIs

Second-line treatment for anxiety

buspirone, TCAs, hydroxyzine, pregabalin, gabapentin, propranolol

Brand name for hydroxyzine

Vistaril

MOA of buspirone

effects may be due to its affinity for 5-HT1A and 5-HT2 receptors

BZDs enhance GABA, an

inhibitory neurotransmitter

Due to the risk of dependence, BZDs should only be used for

1-2 weeks and then discontinued

Which BZDs are preferred in elderly and liver impairment

lorazepam, oxazepam, temazepam (LOT)

(because they under glucuronidation)

All BZDs are

C-IV

Antidote for BZDs

flumazenil

Which BZDs is lipophilic, fast onset, long half-life, high abuse potential

diazepam

Brand name diazepam

Valium

Which BZDs has fast onset and often abused due to its quick action

alprazolam

Brand name for alprazolam

Xanax

Brand name for clonazepam

Klonopin

BZDs commonly used for alcohol withdrawal

lorazepam, diazepam, chlordiazepoxide

Brand name for clorazepate

Tranxene