Pharmacology, part 17: Nervous System Medications for Anxiety

by Cathy Parkes

In this video

Benzodiazepines - lorazepam, diazepam, midazolam, chlordiazepoxide

  • Indications
  • Mode of action
  • Side effects
  • Administration
  • Antidote
  • Tip for remembering

Buspirone (Buspar)

  • Indications
  • Mode of action
  • Side effects
  • Administration
  • Patient teaching
  • Contraindications
  • Tip for remembering

Full Transcript

In this video, we are going to start in on our nervous system medications, and we will first talk about medications that are used for mental health disorders. So if you are following along with cards, I'm on card 55 in our Pharmacology Flashcards Edition 2.0.

Let's start with talking about medications that can be used to treat anxiety.

One such class are benzodiazepines. So medications that fall within this class include lorazepam, diazepam, midazolam, as well as chlordiazepoxide. A lot of these end in that -pam, but obviously chlordiazepoxide does not, but it does have that -diaze- which helps you to remember that it falls within the class of benzodiazepines.

So benzodiazepines can be used to treat anxiety. They can also be used to treat alcohol withdrawal, muscle spasms, seizures, and they are also used in the induction and maintenance of anesthesia.

The mode of action of benzodiazepines is to increase the effect of GABA in the central nervous system.

There are some serious side effects with this class of medication, which can include sedation, respiratory depression, as well as amnesia, and dependency, and withdrawal.

So these medications are not designed for long-term use. So short-term use only is recommended, and we never want to have our patient abruptly discontinue the use of benzodiazepines.

It's also very important to know what the antidote is for benzodiazepines, which is flumazenil. So it is not naloxone or Narcan, which is the antidote for opioid analgesics. It is flumazenil. So I would definitely remember that.

And then my little silly way to remember this is that Pam has anxiety, and she takes lorazepam for that anxiety. However, she does not drive her Benz anymore, her Mercedes Benz, because of the sedating effect of benzodiazepines.

Now let's talk about another medication that is used for anxiety, which is buspirone or Buspar is the brand name.

Buspirone can be used for anxiety, as well as OCD and PTSD.

It works by binding to serotonin and dopamine receptors in the brain, and it also increases norepinephrine metabolism.

So side effects are definitely more minor than what we saw with benzodiazepines. They can include dizziness, nausea, and headache. Sedation is usually not a problem with buspirone.

So for a patient who needs to use an anti-anxiety medication long term, this is definitely a better choice than benzodiazepines.

However, keep in mind that it takes several weeks before the patient feels the full effects of buspirone, so they're not going to take one pill and immediately feel better. It's going to take several weeks.

Also, you want to counsel your patient that they should always take the medication with food or always take it without food to prevent a change in the absorption of buspirone.

Also, grapefruit juice is contraindicated with this medication.

So my little tip for remembering this is if you take a bus to a pier and sit there quietly, it will help to ease your anxiety, just like the effects of buspirone.

Okay, so that's it for our anxiety-only medications that I'm going to go through. In my next video, we will talk about depression medications, and then in the following video, we'll talk about some medications that are used for both anxiety and depression. Thanks so much for watching!

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