Document Detail

Understanding the pharmacokinetics of anxiolytic drugs.
MedLine Citation:
PMID:  23330992     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Anxiety disorders are considered the most common mental disorders and they can increase the risk for comorbid mood and substance use disorders, significantly contributing to the global burden of disease. For this reason, anxiolytics are the most prescribed psychoactive drugs, particularly in the Western world.
AREAS COVERED: This review aims to analyze pharmacokinetic profile, plasma level variations so as the metabolism, interactions and possible relation to clinical effect of several drugs which are used primarily as anxiolytics. The drugs analyzed include benzodiazepines, anticonvulsants (pregabalin, gabapentin), buspirone, β-blockers and antihistamines (hydroxyzine). Regarding the most frequently used anxiolytic benzodiazepines, data on alprazolam, bromazepam, chlordesmethyldiazepam, chlordiazepoxide, clotiazepam, diazepam, etizolam, lorazepam, oxazepam, prazepam and clonazepam have been detailed.
EXPERT OPINION: There is a need for a more balanced assessment of the benefits and risks associated with benzodiazepine use, particularly considering pharmacokinetic profile of the drugs to ensure that patients, who would truly benefit from these agents, are not denied appropriate treatment. An optimal pharmacological approach involving an integrative pharmacokinetic and pharmacodynamic optimization strategy would ensure better treatment and personalization of anxiety disorders. So it would be desirable for the development of new anxiolytic drug(s) that are more selective, fast acting and free from the unwanted effects associated with the traditional benzodiazepines as tolerance or dependence.
Alfredo Carlo Altamura; Donatella Moliterno; Silvia Paletta; Michele Maffini; Massimo Carlo Mauri; Silvio Bareggi
Publication Detail:
Type:  Journal Article; Review     Date:  2013-01-21
Journal Detail:
Title:  Expert opinion on drug metabolism & toxicology     Volume:  9     ISSN:  1744-7607     ISO Abbreviation:  Expert Opin Drug Metab Toxicol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-15     Completed Date:  2013-09-25     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  101228422     Medline TA:  Expert Opin Drug Metab Toxicol     Country:  England    
Other Details:
Languages:  eng     Pagination:  423-40     Citation Subset:  IM    
University of Milan, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Department of Clinical Psychiatry, Via F. Sforza 35, 20122 Milan, Italy.
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MeSH Terms
Adrenergic beta-Antagonists / pharmacokinetics,  therapeutic use
Amines / pharmacokinetics,  therapeutic use
Anti-Anxiety Agents / pharmacokinetics*
Anticonvulsants / pharmacokinetics,  therapeutic use
Anxiety Disorders / drug therapy
Atenolol / pharmacokinetics,  therapeutic use
Benzodiazepines / pharmacokinetics,  therapeutic use
Cyclohexanecarboxylic Acids / pharmacokinetics,  therapeutic use
Histamine Antagonists / pharmacokinetics,  therapeutic use
Hydroxyzine / pharmacokinetics,  therapeutic use
Propranolol / pharmacokinetics,  therapeutic use
Sleep Initiation and Maintenance Disorders / drug therapy
gamma-Aminobutyric Acid / analogs & derivatives,  pharmacokinetics,  therapeutic use
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Amines; 0/Anti-Anxiety Agents; 0/Anticonvulsants; 0/Cyclohexanecarboxylic Acids; 0/Histamine Antagonists; 12794-10-4/Benzodiazepines; 29122-68-7/Atenolol; 525-66-6/Propranolol; 55JG375S6M/pregabalin; 56-12-2/gamma-Aminobutyric Acid; 68-88-2/Hydroxyzine; 6CW7F3G59X/gabapentin

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