Anxiolytics | MedicScientist :: Total Health Portal

Chlordiazepoxide , Amitriptyline

Details About Generic Salt ::  Chlordiazepoxide , Amitriptyline 

Main Medicine Class:: Nervous System   Sub Medicine Class ::  Anxiolytics

1D. ANTI-DEPRESSANTS in 1. NERVOUS SYSTEM
CHLORDIAZEPOXIDE + AMITRIPTYLINE
BENZODIAZEPINE, TRICYCLIC AMINE | ANXIOLYTIC, ANTI-DEPRESSANT
also comes under 1B. Anxiolytics in 1. Nervous System

Indications & Dose: ANXIETY PO Adult Each tablet contains amitryptyline12.5/5mg & chlordiazepoxide 25mg/10mg: Initially 3-4 tablets in divided doses, may increase to 6 tablets/day as required | DEPRESSION PO Adult Each tablet contains amitryptyline12.5/5mg & chlordiazepoxide 25mg/10mg: Initially 3-4 tablets in divided doses, may increase to 6 tablets/day as required

Contra: Hypersensitivity, concomitant MAOIs/after 14 days of MAOIs therapy

Precautions: History of seizures, hyperthyroid patients/those on thyroid medication, impaired renal/hepatic function, patients with suicidal ideation, during drug withdrawal, elderly & debilitated patients, children

ADR: Serious: Hypotension, HTN, tachycardia, palpitations, MI, arrhythmia, heart block, stroke, edema of face & tongue, bone marrow depression, EPS, syncope, paralytic ileus, urinary retention/dilatation of urinary tract, syndrome of inappropriate antidiuretic hormone secretion, gynecomastia & testicular swelling, jaundice, mydriasis, Others: breast enlargement, alteration in blood sugar levels, headache, weight gain/loss, increased perspiration, rash, photosensitization, nausea, vomiting, anorexia, stomatitis, diarrhea, black tongue, Euphoria, delusions, hallucinations, hypomania, increased/decreased libido, ataxia, numbness, tingling, paresthesias of the extremities

DDI: Serious Guanethidine (or compounds with a similar mechanism of action) antihypertensive action may get blocked by drug, TCAs may cause hyperpyretic crises, severe convulsions & death

Monitor: LFTs, CBC

Chlordiazepoxide

Details About Generic Salt ::  Chlordiazepoxide 

Main Medicine Class:: Nervous System   Sub Medicine Class ::  Anxiolytics

1B. ANXIOLYTICS in 1. NERVOUS SYSTEM
CHLORDIAZEPOXIDE
BENZODIAZEPINES DERIVATIVE | ANXIOLYTIC
PK: A: Rapid D: 3.3L/kg (Vd) M: Hepatic E: Urine

Indications & Dose: ANXIETY PO Adult 15-100mg divided 3-4 times/day Child > 6 yrs: 0.5mg/kg/day divided q6-8h | IV Adult Same as IM dose | IM Adult Initially 50-100mg followed by 25-50mg TID/QID as needed Child 0.5mg/kg/24h divided q6-8h | ETHANOL WITHDRAWAL SYMPTOMS PO/IV Adult Initially 50-100mg, may be repeated in 2-4h as necessary, max 300mg/day | MUSCLE SPASMS PO Adult 10-30mg/day in divided doses | PREOPERATIVE ANXIETY IM Adult 50-100mg prior to surgery

Contra: Hypersensitivity to diazepam, myasthenia gravis, respiratory depression, hepatic impairment, sleep apnea, glaucoma

Precautions: History of drug/alcohol abuse, marked personality disorder, renal impairment, avoid prolonged use & abrupt withdrawal, acute porphyria, driving

ADR: Serious: Respiratory depression, hypotension, jaundice, drowsiness, blurred vision, Others: Fatigue, muscle weakness, confusion, dizziness, agitation, insomnia, libido, urinary retention, phlebitis

DDI: Serious Rifampicin/Carbamazepine decreases drug level, Alcohol increases CNS depressant effects, Amitriptyline increases drug adverse reactions, Hormonal Contraceptives increases drug effects/incidence of breakthrough bleeding, Cimetidine increases drug level & reduces drug clearance, Disulfiram increases drug levels/causes drowsiness, Antacids moderately change rate of drug absorption, Phenytoin reduces drug level

Monitor: Respiratory & CV status, mental status

Hydroxyzine

Details About Generic Salt ::  Hydroxyzine 

Main Medicine Class:: Nervous System   Sub Medicine Class ::  Anxiolytics

1B. ANXIOLYTICS in 1. NERVOUS SYSTEM
HYDROXYZINE
ANTI-HISTAMINE | ANTI-PRURTIC, ANXIOLYTIC, SEDATIVE & HYPNOTIC
also comes under 15L. Anti-Pruritic Drugs in 15. Skin,  1A. Sedatives & Hypnotics in 1. Nervous System
PK: A: Rapid

Indications & Dose: ANXIETY Short-term therapy PO Adult 50-100mg QID Child <6 yr: 50mg/day in divided doses, >6 yr: 50-100mg/day in divided doses | Short-term therapy IM Adult Initially 50-100mg, then q4-6h as needed | PREOPERATIVE SEDATION PO Adult 50-100mg Child 0.6mg/kg/dose | IM Adult 25-100mg Child 0.5-1mg/kg/dose | PRURITUS PO Adult 25mg TID/QID Child 6 month-6 yr: Initially 5-15mg HS, increased to 50mg/day in 3-4 divided doses if required, 6-12 yr: Initially 15-25mg HS, increased to 50-100mg/day in 3-4divided doses if required, 12-18 yr: Initially 25mg HS, increased to 50-100mg/day in 3-4divided doses if required

Contra: Hypersensitivity, Sc/intra-arterial/IV administration

Precautions: Narrow-angle glaucoma, prostatic hyperplasia and/or urinary stricture, asthma/COPD, bladder neck obstruction, elderly

ADR: Serious: hypersensitivity reaction, Others: pain/abscess at IM Inj site, drowsiness, agitation, dizziness, headache, asthenia, ataxia, nausea, constipation, dry mouth, urinary retention, wheezing, flushing, bitter taste

DDI: Serious Alcohol increases drowsiness effect of drug, Cimetidine moderately raises drug levels

Monitor: Adverse effects, LFTs

Escitalopram

Details About Generic Salt ::  Escitalopram 

Main Medicine Class:: Nervous System   Sub Medicine Class ::  Anxiolytics

1B. ANXIOLYTICS in 1. NERVOUS SYSTEM
ESCITALOPRAM
SSRIS | ANTI-DEPRESSANT, ANXIOLYTIC
also comes under 1D. Anti-Depressants in 1. Nervous System,  
PK: A: Rapid D: Extensive M: Hepatic E: Urine

Indications & Dose: GENERALIZED ANXIETY DISORDER PO Adult Initially 10mg OD, dose may be increased to 20mg OD after 1 wk | MAJOR DEPRESSION PO Adult Initially 10mg OD, dose may be increased to 20mg OD after 1 wk Child >12 yr: Initially 10mg OD, dose may be increased to 20mg OD after 3 wk Elderly 10mg OD | OBSESSIVE-COMPULSIVE DISORDER PO Adult Initially 10mg OD, dose may be increased to 20mg OD after at least 1 wk | PANIC DISORDER PO Adult Initially doses 5mg OD, increased after a week to 10mg ODWith/without agoraphobia | SOCIAL ANXIETY DISORDER PO Adult Initially 10mg OD, dose may be increased to 20mg OD after at least 1 wk

Contra: Hypersensitivity, concomitant use/within 2 wks of MAOI, concomitant use with pimozide

Precautions: Renal/hepatic impairment, suicidal tendency, elderly

ADR: Serious: Increased risk of suicide/suicidal ideation, serotonin syndrome, Others: drowsiness, dizziness, insomnia, fatigue, rhinitis, sinusitis, nausea, vomiting, diarrhea, constipation, dyspepsia, abdominal pain, dry mouth, erectile dysfunction, libido, increased appetite, flu-like syndrome

DDI: Serious Aripiprazole causes NMS & extrapyramidal symptoms, Fluvoxamine causes serotonin syndrome, Lithium/Carbamazepine decreases drug effects, MAOIs increases drug level & risk of serotonin syndrome, Cimetidine increases drug levels, Citalopram increases risk of serious toxic effects, Pimozide prolongs QT interval

Diet: With/without food

Monitor: Mental status for depression, suicidal ideation, anxiety, social functioning, mania, panic attacks, akathisia

Alprazolam

Details About Generic Salt ::  Alprazolam 

Main Medicine Class:: Nervous System   Sub Medicine Class ::  Anxiolytics

1B. ANXIOLYTICS in 1. NERVOUS SYSTEM
ALPRAZOLAM
BENZODIAZEPINE DERIVATIVE | ANXIOLYTIC, SEDATIVE, HYPNOTIC
also comes under 1A. Sedatives & Hypnotics in 1. Nervous System
PK: A: Rapid D: 0.9-1.2 L/kg (Vd) M: Hepatic E: Urine

Indications & Dose: ANXIETY Acute Short-term therapy PO Adult 0.5-4mg/day in divided doses, max 4mg/day Elderly Initially 0.125-0.25mg BID, increase by 0.125mg/day | ANXIETY WITH DEPRESSION Acute Short-term therapy PO Adult 2.5-3mg/day in divided doses | PANIC DISORDER Acute Short-term therapy PO Adult Initially 0.5mg TID, dose may be increase q3-4 days in increments =1 mg/day, effective dosage is 5-6mg/day | PREOPERATIVE SEDATION Acute PO Adult 0.5mg HS & 0.5mg 1h before procedure

Contra: Hypersensitivity, glaucoma, concomitant use with ketoconazole/itraconazole

Precautions: Respiratory disease, hepatic/renal impairment, elderly, muscle weakness, myasthenia gravis, history of drug/alcohol abuse, marked personality disorder, avoid prolonged use & abrupt withdrawal, acute porphyria

ADR: Serious: Respiratory depression, hypotension, jaundice, blurred vision, Others: agitation, incontinence, insomnia, irritability, libido, phlebitis, urinary retention, Confusion, dizziness, ataxia, fatigue, vertigo, constipation

DDI: Serious Dexamphetamine behavioural effects is reduced, Ketoconazole decreases drug clearance and prolonged its half-life, Theophylline/Carbamazepine decreases drug level, Ritonavir increased sedative effects, Hormonal Contraceptives increases drug effects, Macrolides/Fluvoxamine increases drug level, Alcohol level increases and leads to enhance the CNS depressant effects, CCBs prolongs sedative & amnesic effects, Fluoxetine reduces the drug clearance

Oxazepam

Details About Generic Salt ::  Oxazepam 

Main Medicine Class:: Nervous System   Sub Medicine Class ::  Anxiolytics

1B. ANXIOLYTICS in 1. NERVOUS SYSTEM
OXAZEPAM
BENZODIAZEPINE(SHORT-ACTING) | ANXIOLYTIC
PK: A: Well absorbed M: Hepatic E: Urine

Indications & Dose: ALCOHOL WITHDRAWAL SYMPTOMS PO Adult 15-30mg TID/QID Elderly 10mg TID, may be increased to 10-20mg TID/QID | ANXIETY PO Adult 15-30mg TID/QID Elderly 10mg TID, may be increased to 10-20mg TID/QID | INSOMNIA ASSOCIATED WITH ANXIETY PO Adult 15-25mg 1h before HS, max 50mg

Precautions: Avoid abrupt withdrawal, hepatic impairment, porphyria, history of alcohol/drug abuse

ADR: Serious: Respiratory depression, blood disorders, hypersensitivity reactions, hypotension, Others: Drowsiness, sedation, muscle weakness, ataxia, vertigo, headache, confusion, slurred speech, lethargy, amnesia, pain, thrombophlebitis, libido changes, visual disturbances, urinary retention, GI disturbances

DDI: Serious Alcohol increases drowsiness, impaired performance & driving skills, Hormonal Contraceptives reduces drug effects, Valproic acid/Phenytoin reduces drug level