Psychiatric Mental Health Nursing by Videbeck

disorder or generalized anxiety disorder. Psycho-
logical dependence on benzodiazepines is common:
clients fear the return of anxiety symptoms or believe
themselves incapable of handling anxiety without
the drugs. This can lead to overuse or abuse of these
drugs. Buspirone does not cause this type of physical
dependence.
The side effects most commonly reported with
benzodiazepines are those associated with CNS de-
pression such as drowsiness, sedation, poor coordina-
tion, and impaired memory or clouded sensorium.
When used for sleep, clients may complain of next-day
sedation or a hangover effect. Clients often develop a
tolerance to these symptoms, and they generally de-
crease in intensity. Common side effects from bus-
pirone include dizziness, sedation, nausea, and
headache (Schatzberg & Nemeroff, 2001).
Elderly clients may have more difficulty man-
aging the effects of CNS depression. They may be
more prone to falls from the effects on coordination
and sedation. They also may have more pronounced
memory deficits and may have problems with uri-
nary incontinence particularly at night.

CLIENT TEACHING

Clients need to know that antianxiety agents are
aimed at relieving symptoms such as anxiety or in-
somnia but do not treat the underlying problems that
cause the anxiety. Benzodiazepines strongly potenti-
ate the effects of alcohol: one drink may have the ef-
fect of three drinks. Therefore clients should not
drink alcohol while taking benzodiazepines. Clients
should be aware of decreased response time, slower
reflexes, and possible sedative effects of these drugs
when attempting activities such as driving or going
to work.

2 NEUROBIOLOGICTHEORIES ANDPSYCHOPHARMACOLOGY 39

Table 2-6

ANTIANXIETY(ANXIOLYTIC) DRUGS

Generic (Trade) Name Daily Dosage Range Half-Life (hours) Speed of Onset

BENZODIAZEPINES

Alprazolam (Xanax) 0.75–1.5 12–15 Intermediate

Chlordiazepoxide (Librium) 15–100 50–100 Intermediate

Clonazepam (Klonopin) 1.5–20 18–50 Intermediate

Chlorazepate (Tranxene) 15–60 30–200 Fast

Diazepam (Valium) 4–40 30–100 Very fast

Flurazepam (Dalmane) 15–30 47–100 Fast

Lorazepam (Ativan) 2–8 10–20 Moderately slow

Oxazepam (Serax) 30–120 3–21 Moderately slow

Temazepam (Restoril) 15–30 9.5–20 Moderately fast

Triazolam (Halcion) 0.25–0.5 2–4 Fast

NONBENZODIAZEPINE

Buspirone (BuSpar) 15–30 3–11 Very slow

No alcohol with benzodiazepines

Benzodiazepine withdrawal can be fatal: once

the client has started a course of therapy, he or she

should never discontinue benzodiazepines abruptly

or without the supervision of the physician (Maxmen

& Ward, 2002).