Eldepryl

Definition

Antianxiety drugs are medicines that calm and relax people with excessive anxiety, nervousness, or tension.

Purpose

Everyone feels nervous or anxious once in awhile. Usually, the feeling is related to something happening in the person's life -- an upcoming job interview or a speech to a large audience, for example -- and it goes away when life is back to normal again. This type of anxiety does not need medical treatment. But some people feel anxious almost all the time, or they respond to slightly stressful events with feelings that are out of proportion to the actual situation. The constant anxiety, irrational worries, and sense of impending doom can seriously interfere with their daily lives. For people with such intense or prolonged anxiety, antianxiety drugs can help bring their feelings under control and reduce bothersome symptoms such as pounding heartbeat, breathing problems, irritability, nausea, and faintness.

Antianxiety drugs are prescribed for severe general anxiety and for specific anxiety disorders, such as phobias, panic disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder. Physicians may sometimes prescribe these drugs for other conditions, such as sleep disorders, epilepsy, and other seizure disorders.

Description

There are two main types of antianxiety drugs, also known as anxiolytics or minor tranquilizers. The family of antianxiety drugs known as benzodiazepines includes alprazolam (Xanax), chlordiazepoxide (Librium), diazepam (Valium), and lorazepam (Ativan). The other widely used antianxiety drug is buspirone (BuSpar), which is not a benzodiazepine.

Benzodiazepines take effect fairly quickly, starting to work within an hour after they are taken. The effects of buspirone are not felt until the drug has built up to certain levels in the body. People must take it every day for 2-3 weeks before they will notice any effects.

These medicines are available only with a physician's prescription and are sold in tablet, capsule, liquid, rectal, and injectable forms.

The information that follows applies only to buspirone (BuSpar).

Recommended dosage

The recommended dosage may be different for different patients. The information given here involves average doses. Anyone who takes buspirone should check with the physician who prescribed it for the correct dosage.

Adults

The usual starting dosage of buspirone is 5 mg 3 times a day. The physician who prescribes the medicine may increase the dose by 5 mg a day as needed. The maximum dosage is usually 60 mg per day, but that dosage is rarely used.

Children 18 years and under

Buspirone is not recommended for children under 18 years of age.

Always take this medicine exactly as directed. Never take larger or more frequent doses, and do not take the drug for longer than directed.

This drug may take several weeks for the full effects to be felt. Continue taking the drug every day, even if symptoms do not improve at first. Do not increase the dose or stop taking the medicine unless the physician says to do so.

Precautions

Seeing the physician regularly while taking buspirone is important. The physician will check to make sure the medicine is working as it should and will note unwanted side effects.

Some people feel drowsy, dizzy, lightheaded, or less alert when using buspirone. Anyone who takes these drugs should not drive, use machines or do anything else that might be dangerous until they have found out how the drugs affect them.

Buspirone may add to the effects of alcohol and other drugs that slow down the central nervous system (CNS), such as antihistamines, cold medicine, allergy medicine, sleep aids, medicine for seizures, tranquilizers, some pain relievers, and muscle relaxants. Buspirone may also add to the effects of anesthetics, including those used for dental procedures. Anyone taking buspirone should check with his or her physician before using any CNS depressants.

Special conditions

People with certain medical conditions or who are taking certain other medicines can have problems if they take buspirone. Before taking these drugs, be sure to let the physician know about any of these conditions:

Anyone who has had unusual reactions to buspirone in the past should let his or her physician know before taking it again. The physician should also be told about any allergies to foods, dyes, preservatives, or other substances.

The effects of buspirone have not been studied in pregnant women. However, in animal studies, buspirone has not caused birth defects or other problems when taken during pregnancy. Women who are pregnant or who may become pregnant should check with their physicians before using buspirone.

Whether or not buspirone passes into breast milk is not known. Women who are breastfeeding should check with their physicians before using this medicine.

Before using buspirone, people with any of these medical problems should make sure their physicians are aware of their conditions:

• Current or past drug abuse
• Kidney disease
• Liver disease.

Taking buspirone with certain other drugs may affect the way the drugs work or may increase the chance of side effects.

Side effects

The most common side effects are nausea, dizziness, lightheadedness, headache, restlessness, nervousness, or unusual excitement. These problems usually go away as the body adjusts to the drug and do not require medical treatment unless they persist or they interfere with normal activities.

More serious side effects are rare, but may occur. If any of the following side effects occur, check with the physician who prescribed the medicine as soon as possible:

• Chest pain
• Fast or pounding heartbeat
• Muscle weakness
• Numbness, tingling, pain, or weakness in hands or feet
• Involuntary movements of the body
• Sore throat
• Fever
• Confusion
• Depression.

Other rare side effects may occur. Anyone who has unusual symptoms during or after treatment with buspirone should get in touch with his or her physician.

Interactions

Buspirone may interact with a variety of other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes buspirone should let the physician know all other medicines he or she is taking. Among the drugs that may interact with buspirone are:

• Monoamine oxidase inhibitors, such as phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Eldepryl)
• The blood-thinning drug warfarin (Coumadin)
• Haloperidol (Haldol), used to treat certain mental disorders.

The list above may not include every drug that may interact with buspirone. Be sure to check with a physician or pharmacist before combining buspirone with any other prescription or nonprescription (over-the-counter) medicine.

Key Terms

Anxiety

Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions, such as fast pulse, sweating, trembling, fatigue, and weakness may accompany anxiety.

Epilepsy

A brain disorder with symptoms that include seizures.

Obsessive-compulsive disorder (OCD)

An anxiety disorder in which people cannot prevent themselves from dwelling on unwanted thoughts, acting on urges, or performing repetitious rituals, such as washing their hands or checking to make sure they turned off the lights.

Panic disorder

An disorder in which people have sudden and intense attacks of anxiety in certain situations. Symptoms such as shortness of breath, sweating, dizziness, chest pain, and extreme fear often accompany the attacks.

Phobia

An intense, abnormal, or illogical fear of something specific, such as heights or open spaces.

Post-traumatic stress disorder (PTSD)

An anxiety disorder that affects people who have experienced a severe emotional trauma, such as rape or witnessing a violent death. Symptoms include flashbacks of the traumatic event, anxiety, fatigue, forgetfulness, and nightmares. Also called posttraumatic stress syndrome.

Seizure

A sudden attack, spasm, or convulsion.

Further Reading

Gale Encyclopedia of Medicine. Gale Research, 1999.