benzodiazepine drugs on the market; they differ
primarily in the extent of sedation they cause, the
onset of action, and the length of time they are
active in the body.
BENZODIAZEPINE ANTIANXIETY MEDICATIONSalprazolam chlordiazepoxide
clonazepam clorazepate
diazepam flurazepam
halazepam lorazepam
oxazepam prazepam
temazepam
Buspirone is a unique DRUG that does not
belong to existing chemical classification and is
primarily effective as treatment for moderate to
moderately severe GENERALIZED ANXIETY DISORDER
(GAD). Buspirone does not appear to be particu-
larly effective for treating PANIC DISORDER, OBSES-
SIVE–COMPULSIVE DISORDER (OCD), or PHOBIA. The
person must take buspirone regularly for two to
three weeks before experiencing relief from anxi-
ety symptoms.
How These Medications Work
The benzodiazepines work by binding with neu-
roreceptors on BRAIN neurons for gamma-
aminobutyric acid (GABA), a NEUROTRANSMITTER
that inhibits electrical activity. This binding
extends GABA’s availability, intensifying its
inhibiting actions and consequently inducing
emotional and neurologic calmness and, at high
enough doses, sedation. The mechanisms of bus-
pirone are unknown, though it does not act on
GABA or produce sedation at any dose.
Therapeutic Applications
Doctors commonly prescribe antianxiety medica-
tions to treat mental disorders such as GAD, ACUTE
STRESS DISORDER, panic disorder, POST-TRAUMATIC
STRESS DISORDER(PTSD), phobias, and OCD. Doctors
may also prescribe antianxiety medications, some-
times called anxiolytics, to relieve short-term anx-
iety related to ALCOHOL DETOXIFICATIONas well as to
provide a sense of calm before minor dental
and medical procedures. Many of the benzodi-
azepines have other clinical applications, such as
MUSCLErelaxants and hypnotics (drugs that pro-
vide conscious sedation). Doctors sometimes pre-
scribe benzodiazepines to treat clonic-tonic
seizures in SEIZURE DISORDERSand spasticity in dis-
orders such as CEREBRAL PALSY and SPINAL CORD
INJURY.Risks and Side Effects
Key risks with long-term benzodiazepines are
dependence and tolerance. The longer a person
takes a benzodiazepine medication the more
accustomed the brain becomes to it. Achieving
consistent effects over time often means gradually
increasing the dosage. Suddenly stopping a benzo-
diazepine medication after taking it for longer
than six weeks may result in a withdrawal syn-
drome with various discomforts, including agita-
tion, irritability, HEADACHE, and sleep disturbances.
Doctors recommend tapering the dose over two or
three weeks rather than abruptly stopping a ben-
zodiazepine. Buspirone does not cause depen-
dency or tolerance, though it also can cause
unpleasant symptoms when stopped suddenly.
See also DEPRESSION; MUSCLE RELAXANT MEDICA-
TIONS; VALERIAN.antidepressant medications Medications prima-
rily to treat depression. About 25 percent of adults
in the United States have depression and more
than 80 percent of them take antidepressant med-
ications. There are several classifications, also
called generations, of antidepressant medications.
The drugs in each classification work by some-
what different mechanisms from those in other
classifications.Researchers have linked antidepressant
use in children and teenagers with
increased risk for suicide. The US Food
and Drug Administration (FDA)
requires warnings on the labels of drugs
for which this risk is significant and
cautions parents to closely observe chil-
dren who take antidepressant medica-
tions for signs of increased DEPRESSIONor
expressions of interest in suicide.Monoamine oxidase inhibitors (MAOIs)
Researchers developed the first antidepressant
medications, the MAOIs, in the early 1950s. This
class of antidepressant works by a somewhat dif-360 Psychiatric Disorders and Psychologic Conditions