Anxiety layout 2 NK.

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Appendix 1 – Drugs
Drug Trade Preparation Strength Doses used in Comments Side-effects
name anxiety
disorders (adult)

Anxiety
Anxiolytics
Alprazolam Xanax Tablet 250 mcg, Short-term Contraindicated in respiratory Drowsiness, confusion, ataxia
500 mcg treatment of depression, acute pulmonary (especially elderly), dependence,
anxiety: 250–500 insufficiency, sleep apnoea paradoxical increase in aggression,
mcg 3 times/day syndrome, phobic and muscle weakness
(elderly or obsessional states, chronic
debilitated, renal psychosis, severe hepatic
and hepatic impairment; caution in respiratory
impairment 250 disease, muscle weakness, history

24/9/02
mcg 3 times/day) of drug/alcohol abuse, avoid
(max 3 mg/day) prolonged use and abrupt
withdrawal

Chlor- Librium Capsule 5 mg, Short-term Indicated in short-term treatment Drowsiness, confusion, ataxia
diazepoxide 10 mg treatment of of anxiety; contraindicated in (especially elderly), dependence,
anxiety: 10 mg 3 respiratory depression, acute paradoxical increase in aggression,

2:02 pm
times/day, elderly pulmonary insufficiency, sleep muscle weakness
or debilitated, apnoea syndrome, phobic and
hepatic and renal obsessional states, chronic
impairment half psychosis, severe hepatic
adult dose impairment; caution in respiratory
disease, muscle weakness, history

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of drug/alcohol abuse, avoid
prolonged use and abrupt
withdrawal

Drug Trade Preparation Strength Doses used in Comments Side-effects

name anxiety disorders
(adult)
Anxiolytics

Clorazepate Tranxene Capsule 7.5 mg, Short-term treatment Contraindicated in respiratory Drowsiness, confusion, ataxia (especially
15 mg of anxiety: 7.5–22.5 depression, acute pulmonary elderly), dependence, paradoxical increase
mg/day in 2–3 divided insufficiency, sleep apnoea syndrome, in aggression, muscle weakness
doses, elderly or phobic and obsessional states, chronic
debilitated, hepatic psychosis, severe hepatic impairment;
and renal impairment caution in respiratory disease, muscle
half adult dose weakness, history of drug/alcohol
abuse, avoid prolonged use and
abrupt withdrawal

Diazepam Valium Tablet 2 mg, Short-term treatment Contraindicated in respiratory Drowsiness, confusion, ataxia (especially
5 mg, of anxiety: 2 mg 3 depression, acute pulmonary elderly), dependence, paradoxical increase
10 mg times/day increasing to insufficiency, sleep apnoea syndrome, in aggression, muscle weakness
Valium Oral solution 2 mg/ml 15–30 mg/day in phobic and obsessional states, chronic
Appendix 1 – Drugs

Valium Injection 5 mg/ml divided doses prn, psychosis, severe hepatic impairment;
Stesolid Rectal tubes 5 mg, elderly or debilitated, caution in respiratory disease, muscle
10 mg hepatic and renal weakness, history of drug/alcohol
impairment half adult abuse, avoid prolonged use and abrupt
dose10 mg every 4 withdrawal; I/M and slow I/V injection
hours prn 500 mcg/kg used for severe anxiety and acute panic
every 12 hours prn attacks
(elderly 250 mcg)
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Drug Trade Preparation Strength Doses used in Comments Side-effects
name anxiety disorders
(adult)

Anxiety
Anxiolytics

Lorazepam Ativan Tablet 1 mg, Short-term treatment Contraindicated in respiratory Drowsiness, confusion, ataxia (especially
2.5 mg of anxiety: 1–4 mg/day depression, acute pulmonary elderly), dependence, paradoxical
Ativan Injection 4 mg/ml in divided doses, insufficiency, sleep apnoea syndrome, increase in aggression, muscle weakness
elderly or debilitated, phobic and obsessional states, chronic
hepatic and renal psychosis, severe hepatic impairment;
impairment half adult caution in respiratory disease, muscle
dose 25–30 mcg/kg weakness, history of drug/alcohol

24/9/02
every 6 hours prn abuse, avoid prolonged use and
abrupt withdrawal; I/M and slow I/V
injection used for acute panic attacks;
short acting

Oxazepam Generic Tablet 10 mg, Short-term treatment Contraindicated in respiratory Drowsiness, confusion, ataxia (especially
15 mg, of anxiety: 15–30 mg depression, acute pulmonary elderly), dependence, paradoxical

2:02 pm
30 mg (elderly or debilitated, insufficiency, sleep apnoea syndrome, increase in aggression, muscle weakness
hepatic and renal phobic and obsessional states, chronic
impairment 10–20 mg) psychosis, severe hepatic impairment;
3–4 times/day caution in respiratory disease, muscle
weakness, history of drug/alcohol
abuse, avoid prolonged use and abrupt

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withdrawal; short acting

Drug Trade Preparation Strength Doses used in Comments Side-effects

name anxiety disorders
(adult)

Buspirone
Buspirone Buspar Tablet 5 mg, Short-term treatment Indicated in short-term treatment of Nausea, dizziness, headache, nervousness,
10 mg of anxiety: 5 mg 2–3 anxiety (low dependence potential but light-headedness, excitement
times/day, range response may take up to 2 weeks);
15–30 mg/day in contraindicated in epilepsy, severe
divided doses (max hepatic or renal impairment,
45 mg) pregnancy and breast feeding

Beta adrenoceptor blocking drugs

Oxprenolol Trasicor Tablet 20 mg, Short-term treatment Most suitable for patients with Bradycardia, heart failure, hypotension,
40 mg, of anxiety: 40–80 palpitations, tremor or tachycardia; conduction disorders, bronchospasm,
80 mg mg/day contraindicated in asthma or peripheral vasoconstriction, gastrointestinal
obstructive airways disease, effects, fatigue, sleep disturbances
uncontrolled heart failure,
Appendix 1 – Drugs

hypotension; caution in pregnancy and

breast feeding, hepatic and renal
impairment (reduce dose)

Propranolol Inderal Tablet 10 mg, Short-term treatment Most suitable for patients with Bradycardia, heart failure, hypotension,
40 mg, of anxiety: 40–120 palpitations, tremor or tachycardia; conduction disorders, bronchospasm,
80 mg mg/day contraindicated in asthma or peripheral vasoconstriction, gastrointestinal
obstructive airways disease, effects, fatigue, sleep disturbances
uncontrolled heart failure, hypotension;
caution in pregnancy and breast feeding
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Drug Trade Preparation Strength Doses used in Comments Side-effects
name anxiety disorders
(adult)

Anxiety
Antipsychotic drugs

Chlorprom- Largactil Tablet 10 mg, Short-term treatment Contraindicated in coma caused by CNS Extrapyramidal symptoms (reversed by
azine 25 mg, of severe anxiety: 25 depressants, bone marrow depression; dose reduction and antimuscarinic agents),
50 mg, mg 3 times/day, caution in cardiovascular or hypothermia, drowsiness, apathy, pallor,
100 mg elderly or debilitated cerebrovascular disease, epilepsy, renal nightmares, depression, antimuscarinic
Syrup 25 mg/5 ml one-third to half adult and hepatic impairment, pregnancy and symptoms (dry mouth, constipation,
Suspension 100 mg/5 ml dose breast feeding, hypothyroidism, difficulty with micturition, blurred vision),
forte 25–50 mg every 6–8 glaucoma; deep I/M injection used to cardiovascular symptoms (hypotension,

24/9/02
Injection 25 mg/ml hours control acute symptoms; avoid direct tachycardia, arrhythmias), respiratory
exposure to sun depression, impotence, sensitivity reactions
(blood, photosensitivity, rashes),
neuroleptic malignant syndrome

Fluphenazine Moditen Tablet 1 mg, Short-term treatment Contraindicated in coma caused by CNS Extrapyramidal symptoms (more frequent
2.5 mg, of severe anxiety: 1 depressants, bone marrow depression, than chlorpromazine – reversed by dose

2:02 pm
5 mg mg 2 times/day depression; caution in cardiovascular or reduction and antimuscarinic agents),
increasing to 2 mg 2 cerebrovascular disease, epilepsy, renal hypothermia, drowsiness (less sedating than
times/day prn and hepatic impairment, pregnancy and chlorpromazine), apathy, pallor, nightmares,
breast feeding, hypothyroidism, depression, antimuscarinic symptoms (less
glaucoma frequent than chlorpromazine – dry mouth,
constipation, difficulty with micturition,

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blurred vision), cardiovascular symptoms
(hypotension, tachycardia, arrhythmias),
respiratory depression, impotence,
sensitivity reactions (blood, photosensitivity,
rashes), neuroleptic malignant syndrome

Drug Trade Preparation Strength Doses used in Comments Side-effects

name anxiety disorders
(adult)

Antipsychotic drugs

Haloperidol Haldol Tablet 5 mg, Short-term Contraindicated in coma caused by Extrapyramidal symptoms (more frequent
10 mg treatment of severe CNS depressants, bone marrow than chlorpromazine – reversed by dose
Oral liquid 2 mg/ml anxiety: 500 mcg 2 depression, basal ganglia disease; reduction and antimuscarinic agents),
Injection 5 mg/ml times/day caution in cardiovascular or hypothermia, drowsiness (less sedating than
Serenace Capsule 500 mcg cerebrovascular disease, epilepsy, chlorpromazine), apathy, pallor, nightmares,
Tablet 1.5 mg, renal and hepatic impairment, depression, antimuscarinic symptoms (less
5 mg, pregnancy and breast feeding, frequent than chlorpromazine – dry mouth,
10 mg hypothyroidism, glaucoma; deep I/M constipation, difficulty with micturition,
Oral liquid 2 mg/ml injection used to control acute blurred vision), cardiovascular symptoms
Injection 5 mg/ml, symptoms (hypotension, tachycardia, arrhythmias),
10 mg/ml respiratory depression, impotence, sensitivity
reactions (blood, rashes), neuroleptic
malignant syndrome
Appendix 1 – Drugs

Oxypertine Oxypertine Capsule 10 mg Short-term Contraindicated in coma caused by Extrapyramidal symptoms (less frequent
treatment of severe CNS depressants, bone marrow than chlorpromazine – reversed by dose
anxiety: 10 mg 3–4 depression; caution in reduction and antimuscarinic agents),
times/day (max 60 cardiovascular or cerebrovascular hypothermia, drowsiness, apathy, pallor,
mg/day) disease, epilepsy, renal and hepatic nightmares, depression, antimuscarinic
impairment, pregnancy and breast symptoms (dry mouth, constipation,
feeding, hypothyroidism, glaucoma difficulty with micturition, blurred vision),
cardiovascular symptoms (hypotension,
tachycardia, arrhythmias), respiratory
depression, impotence, sensitivity reactions
(blood, photosensitivity, rashes),
neuroleptic malignant syndrome
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Drug Trade Preparation Strength Doses used in Comments Side-effects
name anxiety disorders
(adult)

Anxiety
Antipsychotic drugs

Pericyclazine Neulactil Tablet 2.5 mg, Short-term treatment Contraindicated in coma caused by CNS Extrapyramidal symptoms (reversed by
10 mg of severe anxiety: depressants, bone marrow depression; dose reduction and antimuscarinic agents),
Syrup 10 mg/5 ml 15–30 mg/day (elderly caution in cardiovascular or hypothermia, drowsiness (more sedating
5–10 mg/day) in 2 cerebrovascular disease, epilepsy, renal than chlorpromazine), apathy, pallor,
divided doses and hepatic impairment, pregnancy and nightmares, depression, antimuscarinic
breast feeding, hypothyroidism, symptoms (dry mouth, constipation,
glaucoma difficulty with micturition, blurred vision),

24/9/02
cardiovascular symptoms (hypotension,
tachycardia, arrhythmias), respiratory
depression, impotence, sensitivity reactions
(blood, photosensitivity, rashes),
neuroleptic malignant syndrome

Perphenazine Fentazin Tablet 2 mg, Short-term treatment Contraindicated in coma caused by CNS Extrapyramidal symptoms (more frequent

2:02 pm
4 mg of severe anxiety: 4 depressants, bone marrow depression; than chlorpromazine – reversed by dose
mg 3 times/day (max caution in cardiovascular or reduction and antimuscarinic agents),
24 mg); elderly cerebrovascular disease, epilepsy, renal hypothermia, drowsiness (less sedating
quarter to half adult and hepatic impairment, pregnancy and than chlorpromazine), apathy, pallor,
dose breast feeding, hypothyroidism, nightmares, depression, antimuscarinic
glaucoma symptoms (dry mouth, constipation,
difficulty with micturition, blurred vision),

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cardiovascular symptoms (hypotension,
tachycardia, arrhythmias), respiratory
depression, endocrine effects, impotence,
sensitivity reactions (blood, photosensitivity,
rashes), neuroleptic malignant syndrome

Drug Trade Preparation Strength Doses used in Comments Side-effects

name anxiety disorders
(adult)

Antipsychotic drugs
Prochlor- Stemetil Tablet 5 mg, Short-term treatment Contraindicated in coma caused by CNS Extrapyramidal symptoms (more frequent
perazine 25 mg of severe anxiety: depressants, bone marrow depression; than chlorpromazine – reversed by dose
Syrup 5 mg/5 ml 15–20 mg/day in caution in cardiovascular or reduction and antimuscarinic agents),
divided doses (max 40 cerebrovascular disease, epilepsy, renal tardive dyskinesia (prolonged
mg/day) and hepatic impairment, pregnancy and administration), hypothermia, drowsiness
breast feeding, hypothyroidism, (less sedating than chlorpromazine), apathy,
glaucoma pallor, nightmares, depression,
antimuscarinic symptoms (dry mouth,
constipation, difficulty with micturition,
blurred vision), cardiovascular symptoms
(hypotension, tachycardia, arrhythmias),
respiratory depression, impotence,
sensitivity reactions (blood, photosensitivity,
rashes), neuroleptic malignant syndrome,
Appendix 1 – Drugs

corneal and lens opacities and skin

pigmentation (prolonged administration)
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Drug Trade Preparation Strength Doses used in Comments Side-effects
name anxiety disorders
(adult)

Anxiety
Antipsychotic drugs
Trifluoperazine Stelazine Tablet 1 mg, Short-term treatment Contraindicated in coma caused by Extrapyramidal symptoms (more frequent
5 mg of severe anxiety: 2–4 CNS depressants, bone marrow than chlorpromazine – reversed by dose
M/R capsule 2 mg, mg/day (max 6 depression; caution in cardiovascular reduction and antimuscarinic agents),
10 mg, mg/day) or cerebrovascular disease, epilepsy, hypothermia, drowsiness (less sedating than
15 mg renal and hepatic impairment, chlorpromazine), apathy, pallor, nightmares,
Syrup 1 mg/5 ml pregnancy and breast feeding, depression, antimuscarinic symptoms (less
hypothyroidism, glaucoma; M/R frequent than chlorpromazine – dry mouth,

24/9/02
formulation should be swallowed constipation, difficulty with micturition,
whole blurred vision), cardiovascular symptoms
(hypotension, tachycardia, arrhythmias),
respiratory depression, impotence,
sensitivity reactions (blood, photosensitivity,
rashes), neuroleptic malignant syndrome

2:02 pm
Tricyclic antidepressants

Clomipramine Anafranil Capsule 10 mg, Obsessional states Contraindicated in recent myocardial Dry mouth, sedation, blurred vision,
25 mg, and social phobia: infarction, arrhythmias, severe hepatic constipation, nausea, difficulty with
50 mg 25 mg/day (elderly impairment; caution in cardiac micturition, cardiovascular effects
10 mg/day), disease, history of epilepsy, (arrhythmias, postural hypotension,

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maintenance pregnancy and breast feeding, thyroid syncope, tachycardia), hypersensitivity
100–150 mg/day disease, psychoses, glaucoma, urinary reactions, mania, weight change,
retention movement disorders, fever, agranulocytosis

Drug Trade Preparation Strength Doses used in Comments Side-effects

name anxiety disorders
(adult)

Reversible monoamine oxidase inhibitors

Moclobemide Manerix Tablet 150 mg, Social phobia: 300 Treat for 8–12 weeks to assess efficacy; Sleep disturbances, dizziness,
300 mg mg/day increasing to contraindicated in acute confusional gastrointestinal effects, headache,
300 mg 2 times/day states, phaeochromocytoma; caution in restlessness, agitation, paraesthesia, dry
on day 4 agitated patients, thyrotoxicosis, mouth, visual disturbances, oedema, skin
pregnancy and breast feeding, hepatic reactions, confusional states
impairment

Reversible monoamine oxidase inhibitors

Citalopram Cipramil Tablet 10 mg, Panic disorder: 10 Caution in epilepsy, history of mania, Gastrointestinal effects (nausea, vomiting,
20 mg, mg/day increasing to cardiac disease, history of bleeding dyspepsia, abdominal pain, diarrhoea,
40 mg 20 mg/day on day 4, disorders, renal and hepatic constipation), anorexia, weight changes,
Oral drops 40 mg/ml range 20–30 mg/day impairment (reduce dose), pregnancy hypersensitivity reactions, palpitations,
Appendix 1 – Drugs

(max 60 mg/day, and breast feeding; avoid abrupt tachycardia, postural hypotension,
elderly 40 mg/day) withdrawal coughing, confusion, impaired
concentration, amnesia, migraine

Escitalopram Cipralax Tablet 10 mg Panic disorder: 5 Caution in epilepsy, history of mania, Gastrointestinal effects (nausea, vomiting,
mg/day increasing to cardiac disease, history of bleeding dyspepsia, abdominal pain, diarrhoea,
10 mg/day on day 7 disorders, renal and hepatic impairment constipation), anorexia, weight changes,
(max 20 mg/day); use (reduce dose), pregnancy and breast hypersensitivity reactions, palpitations,
lower doses in elderly feeding; avoid abrupt withdrawal tachycardia, postural hypotension, impaired
concentration, amnesia, migraine
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Drug Trade Preparation Strength Doses used in Comments Side-effects
name anxiety disorders
(adult)

Anxiety
Reversible monoamine oxidase inhibitors

Fluoxetine Prozac Capsule 20 mg, Obsessive compulsive Caution in epilepsy, history of mania, Gastrointestinal effects (nausea, vomiting,
60 mg disorder: 20 mg/day cardiac disease, history of bleeding dyspepsia, abdominal pain, diarrhoea,
Liquid 20 mg/5 ml for several weeks (max disorders, renal and hepatic impairment constipation), anorexia, weight loss,
60 mg/day) (reduce dose), pregnancy and breast hypersensitivity reactions (angioedema,
feeding; avoid abrupt withdrawal urticaria, anaphylaxis - discontinue if rash
occurs), changes in blood sugar, fever,
neuroleptic malignant syndrome like event

24/9/02
Fluvoxamine Faverin Tablet 50 mg, Obsessive compulsive Treat for 10 weeks to assess response; Gastrointestinal effects (nausea, vomiting,
100 mg disorder: 100 mg/day caution in epilepsy, history of mania, dyspepsia, abdominal pain, diarrhoea,
(max 300 mg/day) cardiac disease, history of bleeding constipation), anorexia, weight loss,
disorders, renal and hepatic impairment hypersensitivity reactions (rash, pruritus,
(reduce dose), pregnancy and breast arthralgia, myalgia, photosensitivity,

2:02 pm
feeding; avoid abrupt withdrawal anaphylactoid reactions, palpitations,
tachycardia, confusion

Page 102
Drug Trade Preparation Strength Doses used in Comments Side-effects
name anxiety disorders
(adult)

Reversible monoamine oxidase inhibitors

Paroxetine Seroxat Tablet 20 mg, Obsessive compulsive Panic symptoms may worsen during Gastrointestinal effects (nausea, vomiting,
30 mg disorder: 20 mg/day, initial treatment for panic disorder; dyspepsia, abdominal pain, diarrhoea,
Liquid 10 mg/5 ml (max 60 mg/day); caution in epilepsy, history of mania, constipation), anorexia, weight loss,
panic disorder: 10 cardiac disease, history of bleeding hypersensitivity reactions (rash, urticaria,
mg/day, (max 50 disorders, elderly, renal and hepatic pruritus, angioedema), extrapyramidal
mg/day); social impairment (reduce dose), pregnancy effects (including orofacial dystonias),
phobia: 20 mg/day and breast feeding; avoid abrupt postural hypotension
(max 50 mg/day); withdrawal (withdrawal syndrome
generalized anxiety reported)
disorder 20 mg/day;
post-traumatic stress
disorder 20 mg/day
(max 50 mg/day)
Appendix 1 – Drugs

Sertraline Lustral Tablet 50 mg, Obsessive compulsive Caution in epilepsy, history of mania, Gastrointestinal effects (nausea, vomiting,
100 mg disorder: 50 mg/day, cardiac disease, history of bleeding dyspepsia, abdominal pain, diarrhoea,
range 50–200 mg/day disorders, renal and hepatic impairment constipation), anorexia, weight loss,
(reduce dose), pregnancy and breast hypersensitivity reactions (rash, erythema
feeding; avoid abrupt withdrawal multiforme, photosensitivity, angioedema,
arthralgia, myalgia), tachycardia, confusion,
amnesia, hallucinations, aggressive behaviour,
psychosis, pancreatitis, hepatitis, jaundice
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Drug Trade Preparation Strength Doses used in Comments Side-effects
name anxiety disorders
(adult)

Anxiety
Other antidepressant drugs

Venlafaxine Efexor Tablet 37.5 mg, Generalized anxiety Treat for 8 weeks to assess response; Nausea, headache, insomnia, somnolence,
75 mg, disorder: 75 mg/day contraindicated in severe renal and dry mouth, dizziness, constipation, asthenia,
150 mg hepatic impairment, pregnancy and sweating, nervousness, convulsions
Efexor XL Capsule 75 mg, breast feeding; caution in history of
150 mg myocardial infarction, history of
epilepsy, avoid abrupt withdrawal

24/9/02
2:02 pm
Page 104
Index

Index
105
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106 Anxiety Index 107