抗焦虑药物使用注意事项
抗焦虑抑郁药物具有抗胆碱作用、嗜睡、失眠／躁狂、体位性低血压、QT间期延长、胃肠道毒性、增重、性功能障碍做以比较。
QT间期延长或间断扭转性室速的风险有高龄、女性、心脏病、先天长QT综合症、低血压或低血镁、血清药物浓度升高（如药物过量、药物相互作用、器官衰竭）以及联合使用QT间期延长的药物。
用药初所有的SSRI和SNRI类药物在最初或剂量增加时都具有短暂的恶心和胃肠道不适。
西酞普兰超过20mg有增加QT间期延长和心律失常的风险
舍曲林与更高的腹泻有关
阿戈美拉汀具有肝毒性，避免与肝损伤的药物合用，需要检测转氨酶。
曲唑酮很少与异常勃起相关，而引起急诊救治
SNRI不具有抗胆碱活性，但是会产生抗胆碱样作用，比如口干和便秘，因此闭角型青光眼应谨慎使用
建议对于老年人和有恶心、头晕、头痛，最初的失眠或激活的敏感个体减少半量或逐渐滴定给予。
苯二氮卓类药物：治疗成人焦虑症或惊恐障碍的常用每日总剂量范围，通常分两到四次给药。
重要提示：所示数据与口服1毫克劳拉西泮的效力大致相等，不建议开始治疗或药物之间的转换。
以上内容见下面图表注意事项中的说明，有些药物不常用可以忽略，目前认为舍曲林、米氮平、西酞普兰和文拉法辛是治疗焦虑抑郁的一线药物需要关注。
* Risk of QTc prolongation or torsades de pointes is also elevated with advanced age, female sex, heart disease, congenital long QT syndrome, hypokalemia or hypomagnesemia, elevated serum drug concentrations (eg, drug overdose, interacting drugs, organ failure) and combination of drugs with QTc prolonging effects. Refer to topic on acquired long QT syndrome.
¶ All SSRIs and SNRIs are associated with transient nausea and gastrointestinal discomfort upon initiation or dose increase.
Δ Based upon reports of dose related QTc prolongation and arrhythmia, the maximum recommended dose of citalopram is 20 mg for patients at increased risk of elevated citalopram serum concentrations.
◊ Sertraline is associated with higher rates of diarrhea.
§ Agomelatine may be hepatotoxic and is contraindicated with any degree of liver impairment. Transaminase monitoring is required.
¥ May cause persistent dose-related increases in blood pressure (primarily diastolic) and heart rate. Monitor blood pressure regularly.
‡ Levomilnacipran has dose dependent effects on urinary hesitancy.
† Trazodone is associated rarely with priapism, which is considered a medical emergency. Refer to UpToDate topic on Serotonin modulators.
** Vilazodone is associated with higher rates of nausea, vomiting, and diarrhea.
¶¶ Caution: can cause liver failure. Not available in Europe, Canada, and several other countries.
ΔΔ Gastrointestinal forms of anticholinergic side effects include: dry mouth, constipation, epigastric distress, decreased esophagogastric tone. Refer to "Anticholinergic" data for frequency rankings.
◊◊ None of the SNRIs have anticholinergic activity. However, SNRIs can produce anticholinergic-like effects (which appear to be mediated by noradrenergic effects on the autonomic nervous system) such as dry mouth and constipation, and should be used with caution in narrow angle glaucoma. In addition, levomilnacipran is associated with urinary hesitancy.
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