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ANTIANXIETY DRUGS

Antianxiety drugs—called ‘anxiolytics’—are prescribed for the treatment of symptoms of anxiety.

There is no class of drugs specifically developed to treat anxiety. Anxiolytics are drawn from the class of drugs called benzodiazepines, and from a number of other classes grouped together for this purpose as ‘non-benzodiazepines’.

Non-benzodiazepines are drugs that act similarly to benzodiazepines, but are chemically (structurally) unrelated. The non-benzodiazepine drugs prescribed to treat anxiety include various antidepressants, barbiturates (rarely prescribed for anxiety these days), some antihistamines, a few other drugs with calming effects, and various herbal preparations which have anxiolytic properties. It is important to note that anxiolytics rarely, if ever, address the cause of the anxiety but simply address the symptoms. 

Be sure to see more complete descriptions of benzodiazepines and antidepressants.

MOST-USED ANTIANXIETY DRUGS

  • Benzodiazepines
    • Ativan
    • Klonopin
    • Librium
    • Valium
    • Xanax

  • Serotonin 1A agonists
    • Buspirone (BuSpar and other brands)

  • Barbiturates
    • Amytal
    • Nembutal
    • Seconal
    • Tuinal

  • Antihistamines
    • Hydroxyzine (Atarax, Vistaril)
    • Chlorpheniramine (Chlor-Trimeton, Chlor-Tripolon)

  • Herbal preparations
    • Valerian
    • Kava
    • Chamomile
    • Kratom

What Is Anxiety?

Anxiety is a natural reaction to stress, and can manifest with symptoms that are physical, emotional, or both. Everyone experiences anxiety in their lives from time to time -- it is basically Nature sending us a message that we are faced with a situation that could become more serious, and we need to come up with a solution right away.

Previously, anxiety that was usually accepted medically as requiring treatment with drugs was more severe and chronic than normal and occasional anxiety. The sufferer cannot deal with, or very often cannot even identify, the source problem. However, it is now not unusual for even minor amounts of anxiety to be treated with a prescription for drugs.

Anxiety symptoms range from constant uneasiness and apprehension to intense dread or panic, and include a wide range of conditions such as:

  • Shortness of breath
  • Chest pains
  • Palpitations
  • Increased blood pressure and heart rate
  • Profuse sweating
  • Rapid breathing
  • Pale skin
  • Stomach aches
  • Nausea
  • Chronic headaches

All of these symptoms create a feeling that  something terrible is about to happen, and the sufferers have no idea what or why. Physically, the body considers that it is preparing to deal with a major threat, and the symptoms are all associated with the well-known ‘fight or flight response’.

Physical Causes of Anxiety

There are numerous proven physical conditions that can bring about pronounced mental and emotional symptoms that look and feel just like the psychiatrists’ drug-targeted anxiety, depression and psychosis.

Dietary insufficiencies and allergies, male or female hormone imbalances, thyroid problems, metal toxicity, environmental allergies, infections of all sorts -- bacterial, viral, parasitic, even common household molds -- and many other physical conditions, have been found to be capable of causing severe mental and emotional symptoms.

Reliable tests exist to discover these physical precursors to mental upsets, and enlightened physicians routinely perform searching evaluations to rule them out before prescribing dangerous psychoactive medications. For almost all such findings, there are specific physical treatments that can effectively treat the source problem, and don’t involve psychoactive medications with unwanted or dangerous side effects.

For all these reasons and more, prescribing antianxiety medications is very often an involved, difficult, time-consuming and uncomfortable trial-and-error process, while physician and patient search for a drug with the least nasty side effects that still has some beneficial effect on the symptoms of anxiety.

As an interesting side note, many cases are on record where the original anxiety disappeared before any medication was found that yielded anything more than discomfort from side effects.

Mental and Emotional Causes of Anxiety

Rather than treating all cases of anxiety with risky drugs, some doctors perform all the physical tests and suggest their patients speak with a priest, minister, good friend, parent or grandparent, to see if you can better address the root cause of the condition.

Instead of relying on completely unproven theories that hold brain chemistry responsible for all mental or emotional ills, maybe your home or workplace contains clues. Often there’s someone nearby who is poisoning your activities, hopes and dreams, or your own behavior needs some improvement.

If you are suffering from unexplained anxiety, there are at least as many reasons, if not more, why you should examine your life rather than just throw chemical bombs into your brain.

More About Antianxiety Drugs

All anxiolytic drugs or preparations exert a calming effect on the symptoms associated with anxiety. Most are central nervous system (CNS) depressants that act to slow activity in the brain and along certain nerve pathways, resulting in various levels of sedation and/or relaxation that also help reduce mental and emotional stress.

Because no two people react to any drug in the same way, in terms of both therapeutic results and the often very unacceptable side effects, the drugs used to treat anxiety can create even worse symptoms than the anxiety. This has continued to drive research to develop drugs with fewer side effects, in turn leading to many different drugs intended for anxiety -- or for that matter for depression, psychosis or any other condition affecting thought, mood and behavior.

And further, because there are no scientific tests that can diagnose purely mental anxiety or any other purely mental condition-- if indeed purely mental conditions even exist -- it has been impossible to create a pill to cure them.

Unlike antibiotics designed to kill specific bacteria and bring about a cure, the causes of most mental problems such as anxiety or depression are completely unknown to medical science. Only the symptoms of purely medical problems can be treated with drugs

SIDE EFFECTS OF ANTIANXIETY DRUGS

The side effects of antianxiety medications are specific to the type of drug used, of which there are many. Side effects are often numerous, uncomfortable, and can be so severe that people would rather put up with anxiety or seek other therapies rather than deal with them.

BENZODIAZAPINES

Please see Benzodiazepines for a complete list and discussion of the side effects of these drugs.

SEROTONIN 1A AGONISTS

The main drug mentioned in this category is buspirone (brand names BuSpar, Ansial, Ansiced, Anxiron, Axoren, Bespar, Buspimen, Buspinol, Buspisal, Narol, Spitomin, Sorbon). Its structure is unrelated to benzodiazepines, but it is said to compare to diazepam (Valium) in treating generalized anxiety disorder.

Side effects of buspirone include:

  • Vertigo
  • Headaches
  • Nervousness
  • Agitation
  • Light-headedness
  • Nausea
  • Drowsiness
  • Insomnia
  • Concentration disorders
  • Confusion
  • Depression
  • Agitation
  • Intestinal disorders
  • Paresthesia
  • Coordination disorders
  • Tremors
  • Disturbed vision
  • Tinnitus
  • Fatigue
  • Weakness
  • Angina pectoris
  • Sore throat
  • Tachycardias
  • Palpitations
  • Dry mouth
  • Pain in muscles and joints
  • Allergic reactions
  • Subdermal bleeding
  • Extrapyramidal symptoms
  • Hallucinations
  • Psychosis
  • Ataxia
  • Epileptic seizures
  • Syncope
  • Tunnel vision
  • Urine retention
  • Hyperosmia
  • Alopecia
  • Pruritus
  • Hot flashes.

Rare side-effects are dangerous in nature or intensity. Some, such as vertigo, agitation and insomnia, disappear with continued use or are less frequent if dosage is low to start and increases gradually. There are no dyscognitive -- ‘brain fog’ --side-effects like those seen in benzodiazepines. An unusual side effect reported by patients was an enhanced sense of smell.

Buspirone has no known potential for abuse, psychological or physical dependence. Obviously, from its long list of side effects, this is the only advantage over the more usually prescribed benzodiazepines.

BARBITURATES

Barbiturates are CNS depressants, producing a wide range of effects from mild sedation to anesthesia. Barbiturates are physically and psychologically addictive, and are lethal when overdosed. For these reasons, barbiturates have largely been replaced by benzodiazepines.

Overdose results when too much is taken at once, or is combined with any other CNS depressants. Overdose results in sluggishness, loss of coordination, confusion, slowness of speech, poor judgment, shallow breathing, coma and death. As with all CNS depressants, a lethal dose varies from one individual to another.

ANITHISTAMINES

Hydroxyzine (Vistaril, Atarax) is 'additive' when combined with other CNS depressants such as opiates or other analgesics, barbiturates or other sedatives, anesthetics or alcohol. This increases the potential for overdose leading to coma and death.

Side effects can include but are not limited to:

  • Deep sleep
  • Loss of coordination
  • Dizziness
  • Hypotension
  • Tinnitus
  • Headache
  • Gastro-intestinal upsets
  • Constipation
  • Dry mouth
  • Hallucinations
  • Confusion

Hydroxyzine is unlikely to cause dependence compared to benzodiazepines such as Xanax and Valium, which have a high potential for abuse and dependence.

Chlorpheniramine, found in Chlor-Trimeton, Chlor-Tripolon, Piriton, Dimetapp, Drixoral, Actifed and other medications, is an antihistamine used primarily to treat allergies and cold symptoms. It’s the only over-the-counter medication said to have mild anxiolytic effects.

Chlorpheniramine is combined with the cough suppressant dextromethorphan in the cold medicine drug Coricidin. It is also combined with the addictive narcotic hydrocodone in the cold brand Tussionex, prescribed for adults and children as young as six years old.

Limited clinical evidence shows that it is comparable to several of the antidepressant medications called SSRIs and SSNRIs in its ability to inhibit the reuptake of serotonin and also norepinephrine. Although not approved as an antidepressant or antianxiety medication, it appears to have anxiolytic properties and is sometimes recommended for this use.

Main side effects of chlorpheniramine include dizziness and drowsiness, and caution is advised when operating machinery while taking the drug.

HERBAL PREPARATIONS

Various herbs exhibit pronounced anxiolytic properties, as well as other beneficial effects on various physical ailments.

Anxiolytic plants and herbs include Valerian, Kava, Chamomile, Kratom, Blue Lotus extracts, Sceletium tortuosum (kanna), Bacopa monniera, and others.

Side effects of these plants and herbs have not been widely clinically researched, and like their anxiolytic properties, are primarily anecdotal.

In almost all cases, they have a long history of use as medications -- even thousands of years -- for a wide variety of common ailments, suggesting that the benefits are real, and that any side effects are mild or non-existent.

DEPENDENCE, ADDICTION AND WITHDRAWAL

Some antianxiety medications -- particularly the benzodiazepines and barbiturates -- create physical and psychological withdrawal symptoms when discontinued. This is the sign of dependence.

Addiction can be seen when a person continues drug use to get 'high' or experience some other drug effect, do things they would not normally do, and go to any lengths to get more of the drug.

MEDICALLY ASSISTED WITHDRAWAL

Medical detox facilities using proper nutrition, hydration and other assistive therapies can help withdrawal from antianxiety medications. Medical drug detox provides a safer, more comfortable and faster detox experience than other older, less effective methods.

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