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