Encyclopedia of Health and Medicine

360 Psychiatric Disorders and Psychologic Conditions
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 MEDICATIONS
alprazolam
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 particularly
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 anxiety
symptoms.
How These Medications Work
The benzodiazepines work by binding with neuroreceptors
on BRAIN neurons for gammaaminobutyric
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 buspirone
are unknown, though it does not act on
GABA or produce sedation at any dose.
Therapeutic Applications
Doctors commonly prescribe antianxiety medications
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, sometimes
called anxiolytics, to relieve short-term anxiety
related to ALCOHOL DETOXIFICATION as well as to
provide a sense of calm before minor dental
and medical procedures. Many of the benzodiazepines
have other clinical applications, such as
MUSCLE relaxants and hypnotics (drugs that provide
conscious sedation). Doctors sometimes prescribe
benzodiazepines to treat clonic-tonic
seizures in SEIZURE DISORDERS and spasticity in disorders
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 benzodiazepine
medication after taking it for longer
than six weeks may result in a withdrawal syndrome
with various discomforts, including agitation,
irritability, HEADACHE, and sleep disturbances.
Doctors recommend tapering the dose over two or
three weeks rather than abruptly stopping a benzodiazepine.
Buspirone does not cause dependency
or tolerance, though it also can cause
unpleasant symptoms when stopped suddenly.
See also DEPRESSION; MUSCLE RELAXANT MEDICA-
TIONS; VALERIAN.
antidepressant medications Medications primarily
to treat depression. About 25 percent of adults
in the United States have depression and more
than 80 percent of them take antidepressant medications.
There are several classifications, also
called generations, of antidepressant medications.
The drugs in each classification work by somewhat
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 children
who take antidepressant medications
for signs of increased DEPRESSION or
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-