| Anti-anxiety (Benzos) | |||
| Medication | Dose range | Labs / monitor | Side effects |
| Benzodiazepam/Valium | 2mg to 10mg, 2 to 4 times daily |
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lightheadedness, hyperactivity, severe drowsiness, seizures, hostility Do not use Benzos with CNS depressants, antihistamines, anticonvulsants, SSRI or alcohol. |
| Clonazepam/Klonopin |
Anxiety 0.25mg PO q12 h; may increase to 1mg/day after three days . Max dose 4mg/day
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| Alprazolam/Xanax | 0.25mg -0.5mg prn anxiety up to 3X/day) max daily dose 4mg give in divided doses; | caution dependance |
tremor, seizure, racing thoughts, confusion, drowsiness Caution dependence |
| Lorazepam/Ativan | 0.5mg- 2mg daily prn up to 3x/day |
if on for longer term check liver and kidney functions
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| Anti-anxiety (non-Benzos) | |||
| Zolpidem/Ambien | 6.25mg for women, 6.25 -12.5 for men. Do not exceed 12.5 mg/Day | caution dependance | hypnotic effects, caution dependance |
| Buspirone/Buspar |
7.5mg 2x/day. Do not exceed more than 60mg/day
Give with SSRI if pt clenches. |
May take 1-2 weeks before effect is felt. Do not eat grapefruit while taking this med |
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COMMENTS:
Benzodiazepam/Valium. Truly lipophilic and crosses the blood-brain barrier. It is unique in that it has true muscle relation effects at a dose equal or less than the amount causing a reduction in anxiety. Acts on spinal cord postsynaptic inhibition through GABA -Treats anxiety, muscle spasms, and skeletal muscle relaxants. Do not use Benzos with CNS depressants, antihistamines, anticonvulsants, SSRI or alcohol.
Clonazepam/Klonopin. Can also prescribe 600-1200 mg of Alpha lipoic acid. If symptoms stop, you can discontinue. Burning mouth/tongue syndrome - Benzo with anticonvulsant properties good for anxiety BMS and TN.
Buspirone/Buspar. Antianxiety med. Binds to 5HT, anti-depressive effects good for chronic anxiety because of not dependence, slower onset of action than Benzo. Give with SSRI if patient clenches.
Zolpidem/Ambien. Works on GABA short-acting with strong sedative