BMS 450 Lecture Notes - Generalized Anxiety Disorder, Buspirone, Benzodiazepine
Document Summary
Avoid any benzodiazepine if suicidal (15% of suicides by od) Mao inhibitors and tricyclines more effective, but greater toxicity. Ssri (selective serotonin reuptake inhibitors) better than benzodiazepines. billion in sales; among most widely prescribed. Hypnotic drowsy, but can always awaken patient. Binds to allosteric site on gaba a receptor. Hyperpolarizes cell, more difficult for neuron to fire. In presence of gaba, increases opening time of cl- channel. Effects correlated with gaba type a receptor binding. Tolerance to all of these effects via the receptor. Death when in combination with alcohol or barbiturates; iatrogenic 250,000 deaths per year. Switch from short to long half-life drugs; taper dose. 4 wks, efficacy vs. placebo (keep treatments <4 wks) 2 wk onset (do not use in acute anxiety) Use for >4 weeks: long-term efficacy not shown. Selective norepinephrine reuptake inhibitors (snri): to be discussed (drugs for depression) Mao inhibitors: to be discussed (drugs for depression)
