sedative antihistamines - hydroxyzine (Atarax 75 up to 250 mg/day) is used more in general medicine and geriatrics than in psychiatric practice. It has powerful antihistaminic and weak anticholinergic effects. It is also an antiemetic.
phenothiazines - chlorpromazine is a well-tried preparation. It can be useful in patients who are particularly likely to become dependent on benzodiazepines.
tricyclic antidepressants - anxiety is a symptom of depressive disorder and in these circumstances a tricyclic is appropriate. Usually a sedative antidepressant is sufficient to deal with depression and anxiety but another anxiolytic may be added for the first two or three weeks (a benzodiazepine is usually appropriate). Tricyclics and MAOI's also relieve anxiety in some chronic anxiety states which do not present with definite depressive symptoms eg panic disorder and phobic states. Their action in these cases is not fully understood, but may relate to a reduction in panic symptoms.
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