ANXIOLYTICS
ا.م.د.جواد الموسوي
An anxiolytic (also antipanic or antianxiety agent) is the medication or
other intervention that inhibits anxiety. This effect is in contrast
to anxiogenic agents, which increase anxiety. Together these categories
of psychoactive compounds or interventions may be referred to
as anxiotropic compounds or agents. Some recreational drugs such
as alcohol(also known formally as ethanol) induce anxiolysis initially;
however, studies show that many of these drugs are anxiogenic.
Anxiolytic medications have been used for the treatment of anxiety
disorder and its related psychological and physical symptoms.
Anxiolytics have been shown to be useful in the treatment of anxiety
disorder. Light therapy and other interventions have also been found to
have an anxiolytic effect.
Beta-receptor blockers such as propranolol and oxprenolol, although not
anxiolytics, can be used to combat the somatic symptoms of anxiety such
as tachycardia and palpitations.
Anxiolytics are also known as minor tranquilizers. The term is less
common in modern texts and was originally derived from a dichotomy
with major tranquilizers, also known as neuroleptics or antipsychotics.
]
There are concerns that some GABAergics, such
as benzodiazepines and barbiturates, may have an anxiogenic effect if
used over long periods of time
o
Selective serotonin reuptake inhibitors
o
Serotonin–norepinephrine reuptake inhibitors
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Barbiturates exert an anxiolytic effect linked to the sedation they cause.
The risk of abuse and addiction is high. Many experts consider these
drugs obsolete for treating anxiety but valuable for the short-term
treatment of severe insomnia, though only after benzodiazepines or non-
benzodiazepines have failed
Benzodiazepines
Main article: Benzodiazepine
Benzodiazepines are prescribed for short-term and long-term relief of
severe and disabling anxiety. 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. If benzodiazepines are discontinued rapidly
after being taken daily for two or more weeks there is some risk
of benzodiazepine withdrawal and rebound syndrome, which varies by
the specific drug.
Tolerance and dependence may also occur, but may
be clinically acceptable.
Cognitive and behavioral adverse effects are
possible.
Alprazolam (Xanax)
Bromazepam (Lectopam, Lexotan)
Chlordiazepoxide (Librium)
Clonazepam (Klonopin, Rivotril)
Clorazepate (Tranxene)
Diazepam (Valium)
Flurazepam (Dalmane)
Lorazepam (Ativan)
Oxazepam (Serax, Serapax)
Temazepam (Restoril)
Triazolam (Halcion)
Benzodiazepines exert their anxiolytic properties at moderate dosage. At
higher dosage hypnotic properties occur.
Tofisopam (Emandaxin and Grandaxin) is a drug that is a
benzodiazepine derivative. Like other benzodiazepines, it possesses
anxiolytic properties, but, unlike other benzodiazepines, it does not
have anticonvulsant, sedative, skeletal muscle relaxant, motor skill-
impairing, or amnestic properties.