.jpg)
Listen here or on your favorite podcast app!
After a (thankfully) brief hiatus, we're back with another listener-supported episode, as one of our correctional physician friends of the show had some serious questions about anxiolytics.
Anxiolytics, or anti-anxiety drugs, are certainly a "hot topic" in corrections, as our provider friend noted. Chris explains why and also provides an overview of the class before addressing the doctor's questions: Are Atarax and Vistaril truly different? Does buspirone actually work? Why does benzodiazepine monotherapy persist despite guideline recommendations? What SSRIs are better for anxiety than others? And more.
Ahead of the main discourse, Chris shares some big medication news regarding Cardiovascular-Kidney-Metabolic (CKM) Syndrome guideline, the FDA approval of Simtriyo for ADHD, new international guidance on low-level HIV viremia, and addresses emerging concerns surrounding compounded peptide therapies.
And because we can't resist looking at the history behind the medications featured in our discussions, we end the show with a look back at the first-ever "blockbuster" anxiolytic, Miltown.
Thanks for listening.
References/further reading:
Into the Clinic:
ACC/AHA/ADA/ASN Cardiovascular-Kidney-Metabolic (CKM)Syndrome Guideline. Released June 9, 2026.
Otsuka Pharmaceutical. FDA Approves SIMTRIYO®(centanafadine) for the Treatment of Attention-Deficit Hyperactivity Disorder(ADHD) in Adults and Pediatric Patients Aged 6 Years and Older. Press release,July 24, 2026.
Clemente T, Stam AJ, Elvstam O, et al; International Consensus Group on the Clinical Management of Low-Level Viremia. Guidance on the clinical management of HIV-1 persistent low-level viraemia on antiretroviral treatment: a scoping review and an international Delphi consensus. Lancet HIV. 2026 Jun 11. doi:10.1016/S2352-3018(26)00107-4.
Janvier S, et al. Counterfeit peptide drugs soldonline contained arsenic, lead, and as little as 5% purity. Talanta. 2018.PMID: 30029448.
FDA Pharmacy Compounding Advisory Committee (PCAC)meeting, July 21–24, 2026 — review of BPC-157, KPV, TB-500, MOTS-C, and relatedpeptides for 503A bulk-substance eligibility.
Main Discussion —Anxiolytics
Vistaril (hydroxyzine pamoate) / Atarax (hydroxyzine hydrochloride) Prescribing Information — QT prolongation and Torsades de Pointes warning.
U.S. Food and Drug Administration. FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. FDA Drug Safety Communication, September 23, 2020.
Brunner E, Chen CA, Klein T, et al. Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits. J Gen Intern Med. 2025;40(12):2814–2859.doi:10.1007/s11606-025-09499-2.
U.S. Department of Veterans Affairs / Department ofDefense. VA/DoD Clinical Practice Guideline for the Management of Substance UseDisorders — benzodiazepine tapering protocols.
Smith RV, Havens JR, Walsh SL. Gabapentin misuse,abuse and diversion: a systematic review. Addiction. 2016;111(7):1160–1174.
Slee A, Nazareth I, Bondaronek P, Liu Y, Cheng Z, Freemantle N. Pharmacological treatments for generalised anxiety disorder: asystematic review and network meta-analysis. Lancet. 2019;393(10173):768–777.
Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10): 1092–1097.
U.S. Department of Veterans Affairs / Department of Defense. VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder (2023) — SSRI and prazosin recommendations.
Trivia Capsule
Wikipedia. Meprobamate.en.wikipedia.org/wiki/Meprobamate.
CBC Radio. Miltown: A Game-Changing Drug You've Probably Never Heard Of. cbc.ca/radio/ondrugs.
TIME Magazine Archive. Drugs: Letdown for Miltown.time.com/archive.
