ATC N — Nervous system

Clonazepam is a long-acting benzodiazepine used in adults for selected forms of epilepsy and for panic disorder. It potentiates GABA-A signalling, with relevant dependence and cumulative sedation risks on prolonged use.

Lamotrigine is an oral antiepileptic and mood stabiliser used in adults and children for partial-onset seizures, primary generalised seizures, Lennox-Gastaut syndrome and bipolar disorder maintenance. Slow titration is essential to minimise serious skin reactions.

Topiramate is an oral antiepileptic and migraine prophylactic used in adults and children. It has multiple mechanisms including sodium channel blockade and GABA enhancement, and is also approved as an adjunct for partial-onset and generalised seizures.

Gabapentin is an oral gabapentinoid used in adults and children for partial-onset seizures and in adults for post-herpetic neuralgia. It is also widely used off-label for various neuropathic pain conditions and restless legs syndrome.

Pregabalin is an oral gabapentinoid used in adults for neuropathic pain, generalised anxiety disorder, fibromyalgia (in some markets) and as adjunctive therapy for partial-onset seizures. It binds the alpha-2-delta subunit of voltage-gated calcium channels.

Lorazepam is an intermediate-acting benzodiazepine used in adults for the short-term treatment of anxiety, status epilepticus and procedural sedation. It potentiates GABA-A signalling, with relevant dependence and cumulative sedation risks.

Alprazolam is a short to intermediate-acting benzodiazepine used in adults for the short-term management of anxiety disorders and panic disorder. It potentiates GABA-A signalling, with a relevant risk of dependence on prolonged use.

Buspirone is a non-benzodiazepine anxiolytic used in adults for generalised anxiety disorder. It acts as a partial agonist at serotonin 5-HT1A receptors, with minimal sedation, no muscle relaxation and a low risk of dependence.

Temazepam is an intermediate-acting benzodiazepine used in adults for the short-term treatment of insomnia. It potentiates GABA-A signalling, with a moderate half-life suited to sleep maintenance and a relevant dependence risk.

Zolpidem is a non-benzodiazepine hypnotic used in adults for the short-term treatment of insomnia. It selectively potentiates GABA-A receptors at the alpha-1 subunit, with a rapid onset and short half-life suited to sleep induction.

Eszopiclone is a non-benzodiazepine hypnotic used in adults for insomnia, including sleep onset and maintenance. It modulates GABA-A receptors with a moderate half-life that supports overnight sleep without long next-day residue.

Amitriptyline is one of the oldest tricyclic antidepressants, in clinical use since 1961. Today it is more commonly used at low dose for neuropathic pain, chronic pain syndromes, migraine prevention and insomnia than for depression, where SSRIs and SNRIs have largely replaced it.

Fluoxetine is the first SSRI introduced into clinical practice, marketed as Prozac since 1987 and known for its very long half-life and active metabolite. It is used for depression, OCD, bulimia nervosa and premenstrual dysphoric disorder, and is on the WHO Essential Medicines List.

Citalopram is a widely prescribed SSRI for major depressive disorder and anxiety, marketed as Celexa and Cipramil. It is the racemic mixture from which escitalopram (the more active S-enantiomer) was developed; modern dosing is capped at 40mg daily because of dose-related QT prolongation.

Paroxetine is one of the older SSRI antidepressants, marketed as Paxil and Seroxat. It has a stronger anticholinergic profile and shorter half-life than other SSRIs, which makes its discontinuation syndrome notably more pronounced and warrants careful tapering.

Sertraline is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder, panic disorder, OCD, PTSD and social anxiety disorder in adults. Marketed as Zoloft and as authorised generics.

Escitalopram is a selective serotonin reuptake inhibitor (SSRI) widely used for major depression and anxiety disorders. It is the active S-enantiomer of citalopram and is marketed as Lexapro and Cipralex.

Trazodone is an atypical antidepressant from the SARI class (serotonin antagonist and reuptake inhibitor). It is FDA-approved for major depression at higher doses but is far more commonly prescribed at low dose (25–100mg at bedtime) for chronic insomnia, where its sedating profile makes it useful.

Mirtazapine is an atypical antidepressant of the NaSSA class (noradrenergic and specific serotonergic antidepressant). It is sedating and appetite-stimulating at low doses, with notably fewer sexual side effects than SSRIs, and is widely used in depression with insomnia, weight loss or anxiety.

Bupropion is an atypical antidepressant that inhibits norepinephrine and dopamine reuptake. It is used for major depression and smoking cessation, and is generally considered to have a favourable sexual side-effect profile compared with SSRIs.

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) used for major depression, generalised anxiety disorder and panic disorder. Originally launched as Effexor, it now has authorised generics widely available in immediate-release and extended-release forms.

Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) approved for depression, generalised anxiety, diabetic peripheral neuropathic pain and chronic musculoskeletal pain. It is widely used as a first-line option when both mood and pain are concerns.