ANXIOLYTICSAss. Prof. Dr. Jawad Al-Musawi
An anxiolytic (also antipanic or antianxiety agent) is the medication or other intervention that inhibits anxiety. This effect is in contrast to HYPERLINK "https://en.wikipedia.org/wiki/Anxiogenic" \o "Anxiogenic"anxiogenic agents, which increase anxiety. Together these categories of psychoactive compounds or interventions may be referred to as HYPERLINK "https://en.wikipedia.org/wiki/Anxiotropic" \o "Anxiotropic"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 HYPERLINK "https://en.wikipedia.org/wiki/Oxprenolol" \o "Oxprenolol" 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 HYPERLINK "https://en.wikipedia.org/wiki/GABAergic" \o "GABAergic" GABAergics, such as benzodiazepines and barbiturates, may have an HYPERLINK "https://en.wikipedia.org/wiki/Anxiogenic" \o "Anxiogenic" anxiogenic effect if used over long periods of time
Selective serotonin reuptake inhibitors
Serotonin–norepinephrine reuptake inhibitors
Monoamine oxidase inhibitors
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.
So, Barbiturates are a class of drugs that have been derived from barbituric acid. Barbituric acid itself has no therapeutic activity; however, its derivatives enhance the action of GABA, a neurotransmitter that inhibits the activity of nerve cells in the brain.
Historically, barbiturates were used in the treatment of anxiety, epilepsy, as anesthetics, and to induce sleep. However, they have a tendency to cause psychological and physical dependence and there is a fine line between a normal dose and a toxic dose. Nowadays, barbiturates have been largely superseded by safer drugs, although some are still used during surgery or to control seizures.
Example of barbiturates:-
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. Benzodiazepines include:
Bromazepam (Lectopam, Lexotan)
Clonazepam (Klonopin, Rivotril)
Oxazepam (Serax, Serapax)
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.