What is the Treatment of Panic disorder?
- -TCAs (imipramine, clomipramine)
- Benzodiazepines (rapid onset of effect)
- -1st choice
What are the Main adverse effects of :
- Initial jitteriness (Gradual dose recommended)
-Sexual dysfunction, Withdrawl syndrome
-Sedation, dependence, withdrawls syndrome, potentiation of alcohol.
What are the treatments for OCD?
What is the treatment for Social anxiety disorder?
- BZD (alprazolam, clonazepam)
- BB (propranolol)
- Cognative behavioral theropy
What are the treatments for PTSD?
- SSRI (sertraline and paroxetine)
- Lithium anticonvulsants (carbamazepine, valproic acid)
What is the treatment of GAD?
- -TCA ( imipramine)
- -SNRI (venlafaxine, duloxetine)
What is Benzodiazepines effect on GABA receptors?
They increase the frequency of the Chloride ion channel opening and cause it to be open longer--> hyperpolarization of the neuron and decreased firing.
What is Benzodiazepines indications?
- Panic Disorder
- EtOH withdrawal
- Anticonvulsant - i.v. diazepam
- Adjunct to anesthesia (midazolam)
Name the Benzodiazepines
What are the adverse effects of Benzodiazepine?
- Psychomotor impairment
- Amnesia (particularly Triazolam)
- Risk for dependence
- Withdrawl syndrome
Describe benzodiazepines Withdrawal effects
After high dose usage, with drawl my include what???
- -Sleep disturbance
- -Myoclonic jerks
- -Sensory disturbances
- -Muscle cramps
-Seizures and Delirium
Name the Benzodiazepine antagonist
How does it work???
- -does not antagonize the central nervous system
- effects of drugs affecting GABA-ergic neurons by means other than the benzodiazepine receptor
- -does not reverse the effects of opioids
- -used to reverse BZD conscious sedation
- -may be useful in suspected BZD overdose
- -Onset 1-2 minutes; duration of effect 4-5 hours
What are some non-Benzodiazepine treatments for anxiety
What is Buspirone?
- -Presynaptic 5-HT1A full agonist
- -Hypothesized 5-HT excess
- -⇩ Neuronal firing
- -⇩ 5-HT synthesis
- -Postsynaptically, partial agonist
- -With 5-HT excess, acts as antagonist
- -With 5-HT deficit, acts as agonist
- -No effects on BZD-GABA receptor complex
When is Buspirone prefferred over Benzodiazepines?
- -Patients with Medical conditions
- -It may improved the sexual dysfunction
- - may be an anti depressent at higher doses
- -Has a slower onset than BZD
What is clonidine?
It is an A2 agonist
- -Alpha-2 agonist can be anxiolytic by decreasing NE release.
- It decreases: Tachycardia, Sweating, Tremor
What are the Denzo and Non-Benzo hypnotics?