Which of the following is a non-benzodiazepine anxiolytic listed for phobia medications?

• A. Buspirone
• B. Alprazolam
• C. Sertraline
• D. Imipramine

Answer: (A)

Non-benzodiazepine options for anxiety disorders are chosen to avoid the sedative effects and dependence risk of benzodiazepines. Buspirone fits this category because it works differently from benzos: it is a serotonin 5-HT1A receptor partial agonist with only modest dopamine activity and does not act on the GABA-A benzodiazepine receptor. This gives it anxiolytic effects without the rapid calming, sedation, or abuse potential associated with benzodiazepines. It’s more suitable for chronic anxiety management and phobic symptoms where immediate relief isn’t needed, though it takes several weeks to become fully effective.

The other choices are not non-benzodiazepine anxiolytics in the same sense. A benzodiazepine provides rapid relief but carries dependence and sedative risks. An SSRI like sertraline is an antidepressant with anxiolytic effects and is used for various anxiety disorders, including phobias, but it isn’t categorized as a non-benzodiazepine anxiolytic in the same class as buspirone. A tricyclic antidepressant like imipramine also treats anxiety but isn’t an anxiolytic class distinct from antidepressants.