Anxiolytic
An anxiolytic is a
drug prescribed for the treatment of
symptoms of
anxiety. Some anxiolytics have been shown to be useful in the
treatment of
anxiety disorders as have
antidepressants such as the class of
selective serotonin reuptake inhibitors (SSRIs).
Though not anxiolytics,
beta-receptor blockers such as
propranolol and
oxprenolol can be used to combat the
somatic symptoms of anxiety.
Types of anxiolytics
Anxiolytics are generally divided into two groups of medication,
benzodiazepines and
non-benzodiazepines.
Benzodiazepines
Benzodiazepines are prescribed for short-term relief of severe and disabling
anxiety. Common medications are
orazepam
(Ativan),
clonazepam (Klonopin),
lprazolam
(Xanax), and
diazepam (Valium). Benzodiazepines may also be indicated to cover the latent
periods associated with the medications prescribed to treat an underlying
anxiety disorder. They are used to treat a wide variety of conditions and
symptoms and are usually a first choice when short-term
CNS
sedation is needed. Longer term uses include treatment for severe anxiety
and sychosis.
There is a risk of
ithdrawal
symptoms and rebound syndrome after continuous usage past two weeks. There is
also the added problem of the accumulation of drug
metabolites and adverse effects.
Serotonin 1A agonists uspirone
(BuSpar) is a
serotonin 1A
agonist. It lacks the sedation and the
ependence
associated with
benzodiazepines and causes much less cognitive impairment. It may be less
effective than benzodiazepines in patients who have been previously treated with
benzodiazepines as the medication does not provide the sedation that these
patients may expect or equate with anxiety relief.
Barbiturates
Barbiturates and
meprobamate exert an anxiolytic effect linked to the sedation they cause.
The risk of abuse and addiction is high. Many experts consider these drugs as
obsolete for treating anxiety, although they may be valuable for the short term
treatment of severe insomnia.
Hydroxyzine
Hydroxyzine is an old
antihistamine originally approved for clinical use by the FDA in 1956. It
possesses anxiolytic properties in addition to its antihistamine properties and
is also licensed for the treatment of anxiety and tension. It is also used for
its sedative properties as a premed before anesthesia or to induce sedation
after anesthesia.
Herbal treatments Certain herbs, such as
valerian, ava
(Kava Kava),
chamomile,
Kratom,
Blue Lotus extracts,
Sceletium tortuosum (kanna) and
bacopa monniera are reputed to have anxiolytic properties. With the
exception of kava kava, only limited evidence exists for their efficacy.
A team from Brazil found
cannabidiol (a constituent of
marijuana) to be an effective anti-psychotic and anxiolytic
'CBD induced a clear anxiolytic effect and a pattern of cerebral activity
compatible with anxiolytic activity). Therefore, similar to the data obtained in
animal models, results from studies on healthy volunteers have strongly
suggested an anxiolytic-like effect of CBD'.
Alternatives to medication
Psychotherapy (e.g. cognitive or behavior therapy) is often useful as an
adjunct to medication or as an alternative to medication. In fact, research has
consistently demonstrated better long-term results for anxiety when treated with
psychotherapy as opposed to pharmacotherapy.
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