9 Types Of Anxiolytics: Medicine For Anxiety

We know that taking a pill does not solve mental pain (although it can provide temporary relief). We know that anxiolytics do not cure anxiety or make your energy-consuming boss disappear.

But they help. They help with emotional pain and increase the effectiveness of psychotherapy and an interdisciplinary approach.

Sociologists say that we live in a dystopian society. Our world buys millions of books on how to be happy every year. Our world filters our images to create a perfect image. Of perfect smiles, perfect happiness.

Because being happy, selling. We all strive for it, but then we take a closer look at our own lives, the skeletons in the closet, where our fears gnaw at us and the shadow of worries catches us.

The pharmaceutical industry is trying to create increasingly sophisticated psychiatric drugs with fewer side effects and faster action. In fact, now there are many types of medications for all kinds of pain in life.

GPs prescribe them too easily sometimes, creating addiction in people who might have solved their problem within an acceptable time with a non-pharmacological strategy.

However, that is the problem. Some pathologies occur internally and require a chemical approach, and some forms of depression of a reactive nature caused by stress would undoubtedly require more than one therapeutic strategy.

In any case, anxiolytics are essential for many people, no doubt, but always only for a certain period of time. Otherwise, we risk falling into a downward medical spiral. And the side effects are sometimes more harmful than the problem itself.

Today we will examine the types of anxiolytics that are on the market today. They aim to treat processes associated with anxiety, insomnia, panic disorders etc.

Main types of anxiolytics

People who need or currently need pharmacological treatment to reduce anxiety know that it is normal to try more than one type, change the dose from time to time, and follow up on how we feel, what we do and the possible side effects. they cause.

• Each individual responds differently to different anxiolytics. Therefore, it is advisable to have the guidance of professionals to guide us in this process.
• Anxiolytics, sedatives and hypnotics are medicines that work in the central nervous system to relieve anxiety or help us fall asleep.

In the same way, it is also a good idea to remember what the action mechanism for anxiolytics is:

• They are soothing. That is, they slow down the body’s functions.
• They are psychotropic drugs that act on the central nervous system. This means that they not only help us relax, but many of them also have sedative, anti-seizure and amnestic effects.
• The mechanism of action is usually simple. They increase the effect of the brain chemical called GABA (gamma-aminobutyric acid). GABA is a type of brain inhibitor that relaxes and reduces the activity of neurons.

Let us now take a closer look at the main types of anxiolytics.

1. Benzodiazepines

Benzodiazepines are the most common “family” of anxiolytics used today. In addition to acting on the drug GABA, it also acts on the limbic system, which inhibits the activity of serotonin in the brain.

• The most common drugs in this class are diazempam, lorazepam, bromazepam, alprazolam and chlorazepat, which we will now describe.
• Most of them produce relaxation, relief from cognitive tension and various calming effects depending on the type of medicine.

Also, depending on the duration and effect on our body, we can make the following classification:

Short-term anxiolytics (effect may last up to 8 hours):

• Bentazepam.
• Clotiazepam.
• Cloxazolam.

Anxiolytics with a medium half-life (effects last from 8 to 24 hours):

• Alprazolam.
• Bromazepam.
• Camazepam.
• Clobazam.
• Ketazolam.
• Lorazepam.
• Oxazepam.
• Oxazolam.
• Pinazepam.

Anxiolytics with a long half-life (effects last more than 24 hours):

• Chlorazepate dipotassium.
• Chlordiazepoxide.
• Chlordiazepoxide + Vitamin B-6.
• Diazepam.
• Halazepam.
• Medazepam.
• Prazepam.

It should be noted that the side effects associated with benzodiazepines are not as severe as the first type of anxiolytic first caused, namely barbiturates.

In addition, we must remember that the administration and consumption of these psychiatric drugs should never exceed 4 to 6 weeks. Otherwise we can develop an addiction.

The most common secondary symptoms associated with benzodiazepines are the following:

• Drowsiness.
• Dizziness.
• Confusion.
• Loss of balance (especially in the elderly).
• Speech disorders.
• Muscle weakness.
• Constipation.
• Dry mouth.
• Unclear vision.

2. Barbiturates

As we just said: before benzodiazepines were on the market, barbiturates were the only anxiolytics available to treat anxiety.

Since the Nobel Prize winner in chemistry, Emil Fischer, discovered barbital in 1902, they emerged as a dangerous but effective resource, which could act as immediate sedatives in the central nervous system.

Later, in 1963, the company “Roche” launched the well-known Valium . With this drug came the era of benzodiazepines. Just a year before – as a curiosity – Marilyn Monroe “probably” committed suicide with a high dose of barbiturates.

But why did they stop being prescribed for the treatment of anxiety?

• Barbiturates and all drugs that contain barbituric acid result in high mental and physical dependence.
• The line between what is considered a normal dose and a toxic dose is also very thin.
• The mechanism of action is based on preventing the flow of sodium to neurons. Currently, its use is reserved only for certain operations and for epilepsy.

These are the most common types of barbiturates:

• Amobarbital (Amytal).
• Apropbarbital (Alurate).
• Butobarbital (Butisol).
• Phentoarbital (Nembutal).
• Secobarbital (Seconal).

3. Buspirone

Buspiron has its advantages and disadvantages. However, it is still a very interesting type of anxiolytic. The main advantage is that it has few side effects, does not interact with other drugs, does not affect cognitive performance and does not cause sedation.

• That is why it is well established in the pharmaceutical market. Doctors like it because of its few side effects.
• However, the negative aspect of buspirone is that it is slow acting. In fact, the patient begins to notice the effects only after 15 days. Of course, this can be a problem, because a person with severe anxiety will feel better as soon as possible, and above all, to be able to sleep.

But experts tell us that it is very effective for anxiety that is not very intense, and highly recommended for older people.

4. Alprazolam

Alprazolam is one of the most commonly prescribed anxiolytics. Many people know it as Xanor. It is a derivative of benzodiazepines and is used primarily to treat panic attacks, agoraphobia and intense stress.

In addition, its chemical properties are very similar to those of tricyclic antidepressants.

• It should be noted that it is a drug with high potency that works immediately, unlike buspirone. It has sedative, hypnotic and anti-seizure properties, but the most noticeable effect is its anxiolytics.
• On the other hand, it is important to know that Alprazolan can be very addictive. To avoid tolerance, it should therefore be used for a limited period.

5. Diazepam

Diazepam or Valium is undoubtedly one of the best known anxiolytics. It is also a derivative of benzodiazepines and the one most commonly used in outpatient and medical centers.

• It is the most effective drug for treating muscle cramps. So in addition to treating anxiety, it also treats psychosomatic disorders, stiff neck, delirium tremens, panic attacks, dyspnea… and it is even used for sedation before surgery.
• Similarly, it should be noted that this type of anxiolytics also causes severe dependence when high doses are used for extended periods.

Lorazepam

Most of us have heard of Lorazepam or “orfidal”. It is very powerful and is used for different purposes:

• Anxiety disorders.
• Sleep disorders, insomnia.
• Tension and stress.
• Some psychosomatic and organic diseases.
• Irritable bowel syndrome.
• Epilepsy.
• It is also used to treat nausea and vomiting caused by chemotherapy or alcohol withdrawal.

Interestingly, lorazepam has an immediate effect and reaches a maximum serum concentration within 2 hours. Also, the side effects are not overly serious.

Although not very addictive, it is recommended that you use it for a limited time.

7. Bromazepam

Bromazepam, better known as Lexatin, is used in low doses to treat anxiety and phobic neurosis. When administered in higher doses, it acts as an effective muscle relaxant, sedative and hypnotic.

It should be noted that bromazepam is a dangerous substance: it quickly causes addiction and interacts with various substances, and is therefore not available in Scandinavia, among other places.

If combined with alcohol, it can be fatal. Therefore, the patient must follow a doctor’s instructions exactly in order for it to work well and be safe.

8. Chlorazepate

Clorazapate is a psychiatric drug that is not registered in Norway, and which has several uses:

• Anxiety.
• Neuroses.
• Psychosis.
• Insomnia.
• It is very effective in treatment for the weaning of alcohol and drugs.
• It is also used to treat irritable bowel syndrome.

Clorazepate can be taken for 3-4 months. Beyond this period, it generates addiction and can also stop working just as well.

9. Antihistamines

It may surprise you that antihistamines are on this list. Are they not usually used to treat allergies?

Well, it is important to note that there are different types of antihistamines. In general, most antihistamines block histamine.

However, it is a type of hydroxyzine, which in addition to relieving the itching caused by allergic skin reactions, reduces brain activity and relieves anxiety and tension.

However, antihistamines are not the most suitable drug for treating anxiety. In fact, psychiatrists do not recommend them if the patient suffers from panic attacks.

Anxiolytics: useful, but be careful

Finally, many more names and options can be added to this list. One is beta-adrenergic blocking drugs, which also include natural alternatives with few side effects.

But the ones we have described here are the most common. They are the doctors prescribe the most, they are on many people’s bedside tables around the world.

Remember that anxiolytics do not cure anxiety. They do not cause panic attacks, neuroses or darkness to disappear.

While these drugs treat, relieve and give us rest (good and necessary things), they do not solve the root of the problem. An exception is if it is a disease of an internal origin, such as some depression.

Therefore, we can use anxiolytics for a limited time, but always combined with psychotherapy. Because  even though “we are what we eat” may be true, “we are what we think” too.

Let’s change our approach and not obsessively medicate things that are sometimes not pathological.

References:

Andrés-Trelles, F. (1993)  Pharmacies used in aging: benzodiazepines and other aniolitis . Madrid: MacGraw Hill Interamericana.

Hardman JG, Goodman LS, Gilman A. (1996) The  pharmacological bases of therapy.  Vol. I. Pages 385-398. Madrid: MacGraw-Hill Interamericana.

Robert Whitaker, (2015) Anatomy of an Epidemic, Madrid: Captain Swing

Eugene Rubin, Charles Zorumski, (2015)  How Many People Take Benzodiazepines? Psychology Today https://www.psychologytoday.com/blog/demystifying-psychiatry/201505/how-many-people-take-benzodiazepines