Rang & Dale's Pharmacology, 6 Edition, 2007, Chapter 37 Objectives

Therapeutic Indications for PharmacotherapyA. Classes of drugs previously or currently in common use for treating generalized anxiety1. Barbiturates (e.g., amobarbital; phenobarbital; butabarbital)2. Propanediol carbamates (e.g., meprobamate [Miltown®; Equanil®])3. Piperazines (hydroxyzine [Atarax®; Vistaril®; other names])4. Benzodiazepines (Chlordiazepoxide [Librium®]; diazepam [Valium®])*5. Azapirones (buspirone [Buspar®])*6. Serotonin reuptake inhibitors (SNRI, SSRI)**currently indicated anxiolytic preparations for generalized anxiety syndromeB. Somatic symptoms of anxiety (in situational anxiety)1. Beta-blockers (e.g., propranolol [Inderal®])C. Obsessive-Compulsive Disorder1. Chlorimipramine (also called clomipramine)(Anafranil®)2. Nontricyclic, selective serotonin reuptake inhibitors (SSRIs)(e.g., fluoxetine [Prozac®]; fluvoxamine [Dumirox®]; paroxetine [Paxil®];sertraline [Zoloft®])D. Phobic anxiety and panic attacks; agoraphobia1. SSRIs and SNRI’s (serotonin and norepinephrine reuptake inhibitors)2. Tricyclic antidepressants (e.g., imipramine [Tofranil®])3. Monoamine oxidase inhibitors (MAO inhibitors) (e.g., phenelzine[Nardil®])4. Triazolobenzodiazepines (i.e., alprazolam [Xanax®])II.GABAergic Synapses and the Mechanism of Action of BenzodiazepinesBenzodiazepines (BZD) remain among the most commonly prescribed drugs in the worldand certainly used frequently for treating anxiety. BZDs are thought to exert their anxiolytic,sedative-hypnotic, anticonvulsant, and skeletal muscle relaxant actions largely by virtue of theirability to enhance the inhibitory action of the neurotransmitter γ-aminobutyric acid (GABA)in the central nervous system. Please see handout on GABA and glutamate.