1. Mental Health Nursing: Pharmacology: Anti-anxiety Medications C. Calzolari 2016

2. Anti – Anxiety Medications (Anxiolytics) Anti-anxiety medications, as the name implies, are prescribed to reduce anxiety. They are prescribed for a number of illnesses:  Generalized Anxiety (GAD)  Post-Traumatic Stress Disorder (PTSD)  Phobias  Obsessive Compulsive Disorder (OCD)  Panic Disorder  Insomnia related to Anxiety

3. Anti – Anxiety Medications (Anxiolytics) There are many classifications of drugs used to treat anxiety:  Benzodiazepines  Antidepressants  Miscellaneous Drugs: BuSpar, Depakote, Tenormin, Inderal.

4. Benzodiazepines Benzodiazepines are considered CNS depressants. How do they work? Enhance the actions of the neurotransmitter, GABA, which slows down brain activity. This produces a drowsy or calming affect. They are used to produce sedation, induce sleep, relieve anxiety and muscle spasms, and to prevent seizures.

5. Benzodiazepines Classified as a controlled substance: Schedule IV. Xanax (alprazolam) Klonopin (clonazepam) Valium (diazepam) Paxipam (halazepam) Ativan (lorazepam) Serax (ozazepam) Centrax (prazepam) Librium ( chlordiazepoxide)

6. Benzodiazepines Side Effects: drowsiness, dizziness, loss of coordination, fatigue, mental slowing, confusion. Withdrawal reactions are possible. S/S: anxiety, shakiness, headache, dizziness, seizures. Precautions: with elderly, lung disease, liver disease, kidney disease, sleep apnea Contraindications: acute narrow angle glaucoma

7. Benzodiazepines Safety Concerns:  risk of addiction: should be only used short term.  Patient should not drive or operate heavy machinery.  Not to be mixed with ETOH, opiates, OTC cough/allergy medications, dental anesthetics – can be life threatening (resp. depression)  Discuss use of OTC medications and supplements and other prescribed drugs with MD before taking them with this type of medication.  MUST NOT be discontinued abruptly. Taper schedule is prescribed.

8. Antidepressants Antidepressants used for anxiety:  Tricyclics – Elavil, Sinequan, Tofranil, Pamelor  MAOIs – Nardil, Parnate  SSRIs –Celexa, Lexapro, Prozac, Paxil, Zoloft  Atypical – trazadone, Effexor

9. Miscellaneous Drugs Used to Treat Anxiety Disorders BuSpar – a mild tranquilizer – affects dopamine levels Depakote – an antiseizure medication Beta Blockers are classified as cardiac medications, but are used for “performance anxiety”. Inderal (propranolol) Tenormin (atenolol)