Anxiety

1. Antianxiety drugs
It is an emotional state, unpleasant in nature, associated with uneasiness,
discomfort and concern or fear about some defined or undefined future.
 Some degree of anxiety is a part of life.
 Treatment is needed when it is disproportionate to the situation and excessive.
 Some psychosis and depressed patients also exhibit pathological anxiety.
 Mostly mild CNS depressants, ill-identified drugs.
Symptoms
 Produce a restful state of mind without interfering with normal mental or
physical functions.
Sreenu Thalla
Associate Professor
Department of Pharmacology

3. The anxiolytic drugs differ markedly from antipsychotics and most closely
resemble sedative-Hypnotic.
They are
 Have no therapeutic effect to control thought disorder of schizophrenia.
 Do not produce extra-pyramidal side effects
 Have anticonvulsant property.
 Produce physical dependence and carry abuse liability.
 Do not selectively block conditioned avoidance response.

4. Classification
1. Benzodiazepenes – Diazepam, Chlordiazepoxide, Oxazepam, Lorazepam, Alprazolam
2. Azapirones – Buspirone, Gepirone, Ispapirone
3. Sedative antihistaminic – Hydroxyzine
4. β- blockers - Propanolol
In addition to this drugs antidepressants, especially Selective Serotonin
Reuptake Inhibitors (SSRIs) are effective in obsessive compulsive disorder, phobias,
panic and severe generalized anxiety disorders.

5. When GABA binds with the
GABAA-receptor,
the permeability of the
central
pore of the receptor to
chloride ions increases
 Enhance the effectiveness
of GABA by
lowering the concentration of
GABA required for
opening the channel.

9. Pharmacological effects
 CNS
 Anxiolytic effect
 Sedative effect
 Skeletal Muscle relaxation
 Anticonvulsant effect
 Anterograde amnesia On Periphery- Neuromuscular blockade (with ↑ dose )
 CVS
 Coronary vasodilatation (with i/v dose)

10. Adverse effects
 Light headedness, Motor in-coordination
 Ataxia, Drowsiness, Confusion, Impaired driving skill and judgment
 Decreased job performance and relationship
 Hang over, Lethargy, Weakness
 Acute over dose
 Prolonged sleep,
 Respiratory and cardiac depression
 CNS depression
 Chronic use
 Tolerance, Dependence
 Hypersensitivity reactions and skin rashes
 Teratogenicity

11. Cilinical Uses
 Treatment of anxiety : Diazepam, Bromazepam , Alprazolam
 For Hypnosis: Diazepam, Midazolam
 For Muscle relaxation : Diazepam, Clonazepam
 In Epilepsy : Clonazepam , Lorazepam
 In Status Epilepticus : Diazepam ( i /v)
 As Preanesthetic medication : Diazepam
 As I/V anesthetic: Diazepam, Midazolam Medical procedures like endosopy
 Diazepam Night terror
 Diazepam Withdrawal from physiological dependence on ethanol/ other sedative-hypnotics
 Psychiatric use: in mania, drug induced hyper excitable states, major depressive illness
 Diagnostically in neuropsychiatry