19. ANTIANXIETY DRUGS Antianxiety drugs (anxiolytics) are CNS depressants which control symptoms of anxiety. They produce a calming effect in anxiety states. Classification of drugs : Benzodiazepines Diazepam Oxazepam Lorazepam Alprazolam "| Azapirones Buspirone Gepirone IspapironeBENZODIAZEPINES Benzodiazepines are the commonly used antianxiety drugs. They have anxiolytic, hypnotic, muscle relaxant and anticonvulsant actions. They are less toxic and addiction liability is very low. : DIAZEPAM: It is an important benzodiazepine compound. Like all other benzodiazepines, it has a hypnotic, anxiolytic, muscle relaxant and anticonvulsant actions. It is quickly absorbed on oral administration. Use: 1) acute panic states 2) anxiety associated with organic disease 3) status epilepticus. Dose :2to 5mg. twice daily. Leanck.d an aral2. OXAZEPAM : This benzodiazepine is slowly absorbed on oral administration. Also, penetration in brain is slow. It has a short duration of action. So it is used mainly in short lasting anxiety states: 3. LORAZEPAM : Like oxazepam, it is slowly absorbed orally and also penetration in brain is slow. It is preferred for short anxiety states. & 4, ALPRAZOLAM : It is a high potency anxiolytic. In addition to : anxiolytic effect, it has a mood elevating action. Also it produces less drowsiness. Good response is obtained in panic disorders. Use: Anxiety states associated with depression. Dose : 0.25 to 1 mg. three times daily.5., BUSPIRONE : It is a new antianxiety drug. It does not have sedative, hypnotic, muscle relaxant and anticonvulsant effects as produced by benzodiazepines. It does not produce tolerance or physical dependence. Buspirone has a slow action and the effect is delayed for even two weeks. Use : mild to moderate anxiety. & Dose: 5 to 15 mg. once or thrice daily. FLUMAZINIL : It is a benzodiazepine antagonist. It binds competitively with benzodiazepine receptors and bldoks many of the pharmacological actions of benzodiazepines. Use: 1) to Teverse benzodiazepine anaesthesia 2) in benzodiazepine over dose -3)hepatic coma and alcohol intoxication.