Anxiety and Depression

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Drug Starting Dose Indication
Anxiety
Xanax
(alprazolam)
0.25 mg po bid-qid anxiety
insomnia
Ativan
(lorazepam)
0.5-1.0 mg po
sublingual prn 4-6 hr
anxiety
insomnia
Haldol
(haloperidol) 
1-3 mg po 6 hr prn anxiety
hallucination
Thorazine
(chlorpromazine)
10-25 mg po 4-6 hr prn hiccough
nausea
agitation
BuSpar
(buspirone)
5 mg tid anxiety
Risperdal
(risperidone)
0.5-1 mg po 12 hr agitation
hallucination
Seroquel
(quetiapine fumarate)
25-100 mg po bid anxiety
hallucination
Sleeping Pills
Restoril
(temazepam)
7.5-15 mg po prn sleeping medication
Lunesta
(zaleplon)
5-20 mg prn sleeping medication
Ambien
(zolpidem)
5-10 mg prn sleeping medication
Sonata
(zaleplon)
5-10 mg prn sleeping medication
Antidepressants
Elavil
(amitriptyline)
15-50 mg po at bedtime sleep disorder
neuropathic pain
Aventyl Pamelor
(nortryptiline)
25-50 mg at bedtime especially in elderly
Desyrel
(trazodone)
25-50 mg po hs or tid depression
anxiety
Paxil
(paroxetine HCL)
20 mg po in am depression
anxiety
Zoloft
(sertraline HCL)
50 mg po in am depression
anxiety
Lexapro
(escitalopram oxalate)
10 mg po in am
5 mg/5ml solution
depression
anxiety
Remeron
(mirtazpine)
15 mg po at bedtime depression
anxiety
anorexia
appetite stimulant
Cymbalta
(duloxetine)
40-60 mg/d depression
neuropathy

Helpful Hints

  • Avoid combining drugs in the same class
  • Consider regular use of anti-anxiety drugs if the prn dose works
  • Start with half doses for elderly patients; they may be susceptible to excessive drowsiness, uncoordination or dizziness
  • Select drugs that can treat a combination of symptoms
  • Therapeutic communication skills (active listening) validate feelings

 

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