Talk:Anxiolytic
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[edit] SSRIs?
SSRIs are commonly prescribed for anxiety. Are they considered anxiolytics? Other than St John's Wort they aren't really mentioned in the article. --Galaxiaad 21:22, 30 July 2005 (UTC)
- SSRIs are not anxiolytic, and St John's Wort is a multiple-reuptake inhibitor, amongst other things. To be considered anxiolytic, immediate relief of symptoms is required, and SSRIs take weeks to provide symptom relief, when at all effective. Studies have shown remarkably low long-term efficiacy of SSRIs in managing anxiety, although intermediate-term efficiacy is usually considered acceptable at sufficiently high doses once the "right one" has been found. Nardil (an MAOI) is generally the best long-term treatment for anxiety, if the patient is capable of following the dietary restrictions. Benzodiazepines, barbituates and carisoprodol are examples of short-term treatments for anxiety -Unregistered
- Don't forget clonazepam. --Jeffreykopp 10/18/2005
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- Sure, there are like a million different drugs out there acting on the GABAergic system, and clonazepam is considered a highly potent benzodiazepine, which was covered by the GP.
- More relevantly, do not forget opiates. The anxiolytic effects of opiates have been known for some time. My SO was fortunate enough to find a doctor willing to prescribe buprenorphine 0.2mg sublingual tablets for as-needed use; it takes about 15 minutes for a fullblown panic attack to fully subside, with no cognitive impairment, and the effect lasts for about 8-12 hours (some patients could theoretically have effect for 48 hours, based on the halflife). At the frequency she was getting the attacks at the time, there was no tolerance buildup at all; rebound effects appear to be nonexistent. Concurrent kappa-antagonism reduces the likelyhood of dependance in case of excessive use, and there will typically also be a significant antidepressant effect (attributable to both µ-agonism and K-antagonism).
- Apart from benzos, barbs, soma, THC and opiates, there are (to my knowledge) no drugs that exhibit what I would call viable intrinsic anxiolytic activity. Sure, some neuroleptics will make you not give a damn about whether you even live or die, but most people I know who have taken them say they'd rather have the attacks; I can relate.
- What these drugs have in common, is that they affect systems that are GABAergic or have efferent connections to GABAergic systems. Drugs lacking this property can safely be assumed to not have any significant short-term anxiolytic potential (exceptional claims and all that), though they may well exhibit long-term anxiolytic effects.
- For management of continous, near-continous or high-frequency anxiety, the gold standard remains Nardil, even in the new formula (which appears to have reduced bioavailability for some patients; the cause has not been investigated, and it would presumably not be economically viable to do so). The reason is simple: it is a GABA-transaminase inhibitor whose primary metabolite is a potent (1mg/kg/dy will do) unselective and irreversible inhibitor of MAO, so it will give both tonic and phasic elevation of GABA, 5HT and DA, the three neurotransmitters that appear to be of primary relevance to the biological basis for anxiety.
- Zuiram 03:43, 3 January 2007 (UTC)
[edit] Beta blockers
I would not consider beta blockers 'anxiolytic' by definition as they work solely on somatic symptoms. Have amended article but could poss. take out.
- Beta blockers are not anxiolytic per se. However, they can have an anxiolytic effect for some people. The reason for this is that the somatic symptoms frequently end up aggravating the anxiety, which becomes a kind of feedback loop. When the somatic symptoms are alleviated, the anxiety will lessen somewhat for these patients, at least breaking the loop, and occasionally helping the patient to recover from an attack as the relief can aid in restoring mental calm.
- Removing them from the page makes little sense, but one could make a note that they do not have any intrinsic anxiolytic properties, rather having an indirect effect that is useful for some patients. That is to say, they will not calm down a person inhaling a high concentration of carbon dioxide, which the other anxiolytics will do; this is a classic test of efficacy. Note that buspirone has a very limited efficacy, and most people who have tried other anxiolytics report no effect whatsoever if switched over to buspirone.
- Zuiram 03:26, 3 January 2007 (UTC)
[edit] Copyvio?
Some of the information on this page appears to be copied from http://www.absoluteastronomy.com/ref/anxiolytic and has been removed by me. This leaves some 'gaps' in the article, there are several other sentences that have been modified by other posters I've kept in. To be honest, I think this needs a complete rewrite - the structure was based on the material taken from the webpage and it's not now in any real order. That's why I added the cleanup tag.Berry 18:57, 25 April 2006
- absoluteastronomy is a Wikipedia mirror. This is not a copyright issue. The text could be restored. Colin°Talk 09:41, 27 April 2006 (UTC)
[edit] Rewrite
I have spent some time rewriting this page. Some things to remember for future editors: anxiolytics are agents used to treat the symptoms of anxiety - not an underlying anxiety pathology such as Generalized Anxiety Disorder. A lot of medications seem to have crept into this article that are not anxiolytics (such as neuroleptics). I've weeded them out. Ifnord 20:44, 24 July 2006 (UTC)
- Thank you! The link dependence goes to a disambiguation page. I was going to change it to physical dependence but I wanted to make sure that was what was intended. I thought "dependence" was used for the physical aspect, and "addiction" for the psychological aspect, but it seems they aren't that well-defined and that it's basically a mess (in usage and on Wikipedia). Anyway, just wanted to check that it does indeed mean physical dependence here. --Galaxiaad 21:32, 24 July 2006 (UTC)
- Indeed it's supposed to be physical dependence. I'll correct it. Ifnord 20:10, 25 July 2006 (UTC)
[edit] Etifoxine and Stresam
Could someone please add some information about the non-benzodiazepine anxiolytic etifoxine. It seems Stresam, a popular drug particularly in France for treating anxiety, makes use of this. Someone I know was on it, so I'm eager to find out more, but there doesn't seem to be info on Wikipedia yet. —The preceding unsigned comment was added by Steve Kroon (talk • contribs) 06:54, 26 March 2007 (UTC).
