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Anxiolytic Treatment: Classification, Doses, Adverse Effects

Anxiolytic Treatment: Classification, Doses, Adverse Effects

Mechanisms & classification

Start dose

Usual therapeutic daily dose

Lethality in overdose

Insomnia
and/or agitation

Sedation

Nausea or GI effects

Sexual dysfunction

Weight gain

Benzodiazepines

alprazolam

0.25-0.5 mg tid

1-4 mg

No (unless if combined with other CNS drugs)

++

+++

++

++

++

chlordiazepoxide

5 mg qd

10-100 mg

No (unless if combined with other CNS drugs)

Frequency unknown

++

Rare

Rare

Frequency unknown

clonazepam

0.25 mg bid

1-2 mg

No (unless if combined with other CNS drugs)

+

++

Rare

+

+

oxazepam

10 mg tid

30-60 mg

No (unless if combined with other CNS drugs)

Frequency unknown

++

Rare

Rare

No

Selective serotonin reuptake inhibitors

citalopram

10 mg qd

10-20 mg

No

+++

+++

+++

++

+

escitalopram

10 mg qd

10-20 mg

No (unless if combined with other CNS drugs)

++

++

+++

++

+

paroxetine

20 mg qd

20-60 mg

No (unless if combined with other CNS drugs)

++

++

+++

+++

++

Serotonin and norepinephrine reuptake inhibitors

duloxetine

30 mg qd

30-60 mg

Yes
(at > 1000 mg)

++

+++

+++

++

+

venlafaxine

75 mg qd

75-225 mg

Yes

+++

+++

+++

++

++

Others

buspirone

5 mg bid or tid

15-60 mg
(60 mg)

No

++

+++

++

No

Frequency unknown

hydroxyzine

12.5-25 mg

25-100 mg
(100 mg)

No

Frequency unknown

+++

Frequency unknown

No

No


Frequencies of adverse effects as reported in clinical studies, frequencies are not placebo-corrected.
Rare (> 1/10,000 to < 1/1000): rare
Uncommon (> 1/1000 to < 1/100): +
Common (> 1/100 to < 1/10): ++
Very common (> 1/10): +++

The information on the starting dose and side effects is mostly issued from the European product label of the individual drug