Drugs for Anxiety & Affective Disorders

This module covers the core medications used for:

Anxiety disorders (GAD, panic, OCD, PTSD, social anxiety)
Affective disorders (depression and related mood syndromes)

Most anxiety disorders are comorbid with depression → SSRIs/SNRIs are the foundation

Lecture Resources

📄 Lecture Handout (PDF)

▶ Lecture Video (YouTube)

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Anxiety Disorders

First-Line Classes

SSRIs
SNRIs

Affective Disorders

Symptom-Based Add-Ons

Drugs to Know

Two classes are used most often for anxiety: Benzodiazepines and SSRIs/SNRIs

Antidepressants

Selective Serotonin Reuptake Inhibitors (SSRIs)

Citalopram (Celexa®)
Escitalopram (Lexapro®)
Fluoxetine (Prozac®)
Fluvoxamine (Luvox®)
Paroxetine (Paxil®)
Sertraline (Zoloft®)

Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)

Desvenlafaxine (Pristiq®)
Duloxetine (Cymbalta®)
Levomilnacipran (Fetzima®)
Milnacipran (Savella®)
Venlafaxine (Effexor®)

Tricyclic Antidepressants (TCAs)

Amitriptyline (Elavil®)
Amoxapine
Clomipramine
Desipramine (Norpramin®)
Doxepin (Silenor®)
Imipramine (Tofranil®)
Nortriptyline (Pamelor®)
Protriptyline
Trimipramine

MAO Inhibitors (MAOIs)

Atypical / “Add-On” Antidepressants

NDRI

Bupropion (Wellbutrin®)

Alpha-2 Antagonist

Mirtazapine (Remeron®)

Serotonin Modulators / Multimodal Agents

Trazodone (Desyrel®)
Nefazodone (Serzone®)
Vilazodone (Viibryd®)
Vortioxetine (Trintellix®)

Anxiety-Specific Agents

Benzodiazepines (GABA-A PAMs)

Diazepam (Valium®)
Lorazepam (Ativan®)
Clonazepam (Klonopin®)
Alprazolam (Xanax®)

5-HT1A Partial Agonist

Buspirone (Buspar®)

Antihistamine (Anxiolytic)

Hydroxyzine (Vistaril®/Atarax®)

Beta-Blocker (Performance Anxiety)

Propranolol

Rapid-Acting / Newer Agents

NMDA Modulators

Neurosteroid GABA-A Modulators

Mood Stabilizers

Antidotes / High-Yield Extras

Cyproheptadine (serotonin syndrome antidote)