Anxiolytic
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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.
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[edit] Types of anxiolytics
Anxiolytics are generally divided into two groups of medication, benzodiazepines and non-benzodiazepines.
[edit] Benzodiazepines
- Main article: Benzodiazepine
Benzodiazepines are prescribed for short-term relief of severe and disabling anxiety. Common medications are lorazepam (Ativan®), clonazepam (Klonopin®), alprazolam (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 psychosis. There is a risk of withdrawal 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.
[edit] Non-benzodiazepines
Buspirone (Buspar®) is a serotonin 1A agonist. It lacks the sedation and the dependence 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 euphoria and sedation that these patients may expect or equate with anxiety relief.
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.
[edit] Herbal treatments
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Certain herbs, such as St. John's wort and kava (kava kava), have been used as anxiolytics, but limited reliable evidence is available for their efficacy. In Europe, the root of the valerian is also popular as an anxiolytic.
There are herbal treatments that have been used in India for ages, including Bacopa. After thousands of years of use in Indian Ayurvedic medicine, Bacopa monnieri has been proven to be an effective anxiolytic in over 30 clinical studies. It has been shown to be comparable to lorazepam, although unlike benzodiazepines which can cause amnesic action, this herb promotes cognition and increases memory. There are no known side effects regarding the use of Bacopa, nor does it contain addictive ingredients.
Use of marijuana as a anxiolytic has seen promising results in regions where its practical study is possible, but its status as a narcotic and controlled substance in many countries make its study as such difficult.
[edit] Alternatives to medication
Psychotherapy (e.g. cognitive or behavior therapy) is often useful as an adjunct to pharmacotherapy or as an alternative to medication.
[edit] References
- Albers, Lawrence; Rhoda Hahn, Christopher Reist (2001-2002). Handbook of Psychiatric Drugs. Laguna Hills, California: Current Clinical Strageties.
