1. Chapter 10- Benzodiazepines Anti-Anxiety

2. Intro  Introduced in 1960s  Quickly replaced barbiturates  12 are used in the US Page113  Treat insomnia, anxiety, seizures  Addictive

3. Medical Uses  Remain the treatment of choice for anxiety disorders such as panic attacks or GAD  Even though there are new Serotonin reuptake inhibitors- SSRI that are great for Anxiety physicans still use  Seizure d/o- Clonipin works well

4. Pharmacology  Lipid soluble  Taken orally  Half-life of 1.7-100 hours  Duration of effect for as long as 280 hours after single dose  Inhances the effects of GABA-drug reduces the level of activity, lowering anxiety

5. Side effects  Sedation  Drug induced hangovers  Visual motor disturbances MVA

6. Addiction  Controversy over this  Some say not addictive, while other say this drug should not be used longer that 4 weeks due to abuse  W/D – seizures, shakes, tremors, irritabiltiy, vomiting, insomnia, death  Substance user more likely to abuse this drug, not to be administered to

7. Withdrawal is difficult  Taper very slowly for as long as 8-12 weeks  Should use a mood stablizer such as Seroquel to help with the anxiety

8. BuSpar  Newer drug as good at controlling anxiety  Rarely sedates  Does not control seizures  Great for treatment of anxiety where there is also depression  Marketed as non-addictive

9. Ambien  New family of sleep inducing drug  Dose should not exceed 10 mg per day  Abuse potential low  Should not be used in people with addictive d/o, effects can trigger use