netFormulary Leicestershire Health Community NHS
Medicines Formulary  
 Formulary Chapter 4: Central nervous system - Full Chapter
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04.01.02  Expand sub section  Anxiolytics
  • Limit to short period of time and review CSM Advice
  • Diazepam and its active metabolite have a long half life. There is a potential for accumulation especially in the very elderly.
  • Diazepam should only be given by the intramuscular route when oral and intravenous routes are not possible
  • Propranolol can often relieve the somatic symptoms of anxiety without the risks associated with benzodiazepine dependence
  • General Anxiety Disorder and Panic Disorder treatment options include antidepressant therapy
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Lorazepam is shorter-acting than diazepam and seems more likely to produce dependence. For this reason it should only be prescribed as an anxiolytic for existing users or where treatment will be for a very short time (e.g. for its amnesic effect when a course of cytotoxic chemotherapy is administered). Lorazepam may occasionally be useful in calming an acutely agitated patient if used with an antipsychotic agent such as haloperidol.


Link  LPT Guidance: Rapid Tranquilisation Policy
Link  UHL Guidelines: Rapid Tranquilisation of Disturbed Adult Patients
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