ANTI ANXIETY AGENTS / DRUGS USED IN THE TREATMENT OF ANXIETY for B.Pharm & Pharm.D

1. BY- DR.S.KAMESHWARAN
ANTI
ANXIETY
DRUGS

2. ANXIETY:
“It is an emotional state, unpleasant in nature,
associated with uneasiness, discomfort and
fear about some defined or undefined future
threat”
In normal life some degree of anxiety is
common
But treatment needs when it increases

3. ANTI ANXIETY DRUGS:
“They are mild CNS depressants, control the
symptom of anxiety and produce a rest full
state of mind, without interfering normal
mental / physical function.”
Anti anxiety drugs more closely resembles
sedative hypnotics
Do not produce extra pyramidal side effects
Have anticonvulsant property
Produce physical dependence & carry
abuse liability.

4. ANTI ANXIETY DRUGS CLASSIFICATION
 BENZODIAZEPINES
CHLORDIAZEPOXIDE
DIAZEPAM
OXAZEPAM
 AZAPIRONES
BUSPIRONE
GEPIRONE
ISPAPIRONE
 SEDATIVE ANTIHISTAMINIC
HYDROXYZINE
 BETA BIOCKER
PROPRANOLOL

5. BENZODIAZEPINES (BZD):
Commonly used anti anxiety drug,
Some BZDs have slow and prolonged activity
Relieve anxiety at low dose without producing
CNS depression
it also have hypnotic, muscle relaxant,
anticonvulsant activity
Less toxic and low addiction liability,
Better quality and quantity of improvement in
anxiety and stress than the barbiturates
At anxiety dose it produces minor
cardiovascular and respiratory depression.

6. Eg: CHLORDIAZEPOXIDE
It was the first BZD to be used clinically
Produce smooth long lasting effect
Preferred in chronic anxiety status
Often combined with other drugs
Has poor anti convulsant action.

7. MECHANISM OF ACTION:
BENZODIAZEPINES
↓
BINDS TO BZD RECEPTOR PRESENT IN THE Α SUB UNIT
OF GABA-A RECEPTOR
↓
IT INCREASE THE BINDING OF GABA TO THE GABA-A
RECEPTOR
↓
INCREASES THE INFLUX OF MORE Cl- IONS IN TO
INTRACELLULAR SITE
↓
HYPERPOLARIZATION
↓There by it produce
CALMING EFFECT
↓
ANTI ANXIETY ACTIVITY

9. PHARMACOKINETICS:
Oral absorption slow
T1/2 5 to 15 hours
ADR:
Dizziness
Vertigo
Ataxia
Disorientation
Amnesia

10. Dizziness

11. Dizziness

12. Vertigo

13. Ataxia

14. AZAPIRONES
Eg: Buspirone
It is the First Azapirone
Newer anti anxiety drug
It relieves mild to moderate generalized anxiety
It is ineffective at severe cases
Dose not interact with BZD receptors
Doesn’t produce tolerance or physical
dependence
It does not have sedative, hypnotic muscle
relaxant activity like BZD

15. MECHANISM OF ACTION:
• Not clearly known
• Anti anxiety activity might be due to
Agonist activity on 5 HT1A receptors
Weak dopamine D2 blocking action

16. PHARMACOKINETICS:
Rapidly absorbed orally
Effect develops slowly
Maximum benefits may be delayed up to 2 weeks
Extensive first pass metabolism
Excreated in both urine and feaces
ADR:
Dizziness
Nausea
Headache
Excitement

17. BETA BIOCKER:
Many symptoms of anxiety like
palpitation,
rise in BP,
shaking,
tremor,
gastro intestinal hurrying
- occurs due to sympathetic over activity
The beta blockers produce symptomatic relief from
the anxiety
But they do not affect psychological symptoms
They may be used as adjuvant along with BZD

18. THANK U