Pharmacology for Dentistry

Psychotropic Agents 99

is discussed in chapter ‘Sedative and
hypnotics’.

They have selective action on limbic sys-
tem and have little effect on other body sys-
tems. They help in improving the anxiety and
stress related symptoms. They are widely
used because of lower dependence produc-
ing liability and wide margin of safety.

AZAPIRONES

BUSPIRONE

It belongs to azapirones which is chemi-
cally and pharmacologically distinct class.
It acts as a partial agonist at serotonin and
dopamine receptors and having no hypnotic
and sedative action. It does not interact with
benzodiazepine receptor or modify GABA-
ergic transmission.

It is rapidly absorbed and undergoes
extensive first pass metabolism and excreted
through kidney and faeces.

It is used in short-term management of
anxiety disorders and relief of symptoms of
anxiety with or without accompanying de-
pression.

Adverse effects include headache, ex-
citement, tachycardia, palpitation (may raise

BP in patients on MAO inhibitors), nervous-

ness, dizziness, drowsiness, confusion, fa-

tigue, sweating etc.

OTHER COMPOUNDS

HYDROXYZINE

It is antihistaminic agent having anti-

emetic, sedative, anticholinergic and local

anaesthetic property. Used in anxiety, pru-

ritus and dermatoses; as an adjunct therapy

in acute/ chronic alcoholism.

Side effects include epigastric distress,

nausea and impaired alertness.

BETA BLOCKERS

Beta blockers provide symptomatic re-

lief by decreasing the symptoms due to sym-

pathetic overactivity e.g. palpitation, trem-

ors, rise in BP, etc. They may be used as ad-

juvant to benzo-diazepines.

ANTIDEPRESSANTS

They are classified into two main categories

e.g. MAO inhibitors and tricyclic/tetracyclic

antidepressants as in table 2.5.3.

MAO INHIBITORS

Monoamine oxidase (MAO) is an intra-

cellular enzyme and metabolizes intracellu-

Table 2.5.2: Classification of antianxiety drugs.

I. Benzodiazepines

Diazepam, lorazepam, oxazepam, alprazolam. Details are already given in chapter ‘Sedative and hypnotics’

along with trade name and dose also.

II. Azapirones

Buspirone (BUSPIDAC) 5-15 BD-TDS

III.Others

Hydroxyzine (ATARAX) 25-100 mg TDS-QID

Meprobamate

Beta blockers e.g. propranolol.