What are antianxiety medications?

Quick Answer
A wide variety of medications are used to treat anxiety disorders. The medications most commonly used are either antidepressants or anxiolytics.
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Introduction

More people develop anxiety disorders than any other mental health problem. In part, this is because there are many types of anxiety disorders, including generalized anxiety disorder (GAD), panic disorders, social anxiety, and post-traumatic stress disorder (PTSD). Individuals with anxiety disorders can be treated with psychotherapy, medication, or a combination of the two. When medications are used, they tend to be either antidepressants or anxiolytics. Antidepressants are used to treat anxiety disorders as well as depression, because both of these disorders often exhibit a lack of neurotransmitters in the cells within the brain. It has been shown that when people exhibit anxiety, there is increased activity within the amygdala (part of the limbic system). Increased presence of neurotransmitters has been correlated with decreased activity in the amygdala and decreased anxiety. Bothselective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) have been used to treat depression and certain anxiety disorders. SSRIs, such as paroxetine (Paxil), fluoxetine (Prozac), and escitalopram (Lexapro), increase the amount of serotonin in the cells of the brain by inhibiting (preventing) their reuptake. SNRIs, including venlafaxine (Effexor) and duloxetine (Cymbalta), inhibit the reuptake of both norepinephrine (noradrenaline) and serotonin. Increasing the amounts of both of these neurotransmitters improves transmission of impulses along the neuron, thereby improving affect and decreasing anxiety.

Anxiolytics

Anxiolytics is the term for a category of medications that are commonly used to treat generalized anxiety disorders and panic disorders. These drugs are sometimes referred to as minor tranquilizers, but this is somewhat of a misnomer as the mechanism of action for these medications is not really understood. However, it is felt that the effect of most anxiolytics is tied into the functioning of gamma-aminobutyric acid (GABA). GABA is an inhibitory neurotransmitter that renders brain cells in the area of the amygdala less likely to respond to excitatory neurotransmitters, making individuals less likely to suffer from anxiety reactions.

Benzodiazepines are the most common type of anxiolytics. Diazepam (Valium), alprazolam (Xanax), and lorazepam (Ativan) are the most commonly used benzodiazepines in the United States. Benzodiazepines are typically used to treat anxiety for only short periods of time. They are often used as the first means of treatment for severe anxiety reactions. Individuals are not likely to remain on these medications for a long period of time because of severe side effects (including oversedation), dependence, and problems with withdrawal.

Other anxiolytics include azapirones and barbiturates. Azapirones, such as buspirone (BuSpar), appear to work by increasing the activity of serotonin in the brain. They work relatively slowly, taking two to four weeks to have an effect. Their chemical composition is dramatically different from that of most of the other drugs used to treat anxiety. They act more slowly, have fewer side effects, and are better tolerated. There are almost no reported cases of dependence or oversedation from azapirones. Barbiturates, including secobarbital (Seconal) and pentobarbital (Nembutal), were commonly used to treat anxiety in the past. Although their mechanism of action in treating anxiety is still unknown, it is believed that they also work on GABA reactors in the brain. They are generally considered to be sedative-hypnotics and as such have many adverse effects and great risk of dependence and withdrawal reactions. Therefore, with the advent of the newer anxiolytics, barbiturates have become much less commonly used in the treatment of anxiety disorders.

As with most categories of medication, there are some over-the-counter and natural remedies that have been used to treat anxiety. The nutritional supplement most commonly used to treat anxiety is GABA. Although this amino acid is produced naturally in the brain, if people have poor nutritional habits, they may not be ingesting adequate precursors for this inhibitory neurotransmitter. In such individuals, this nutritional supplement has been found to lessen symptoms of depression and decrease anxiety.

If a person has developed an anxiety disorder, many different types of treatment are available. Which treatment is chosen should always depend on characteristics of the individual as well as the type and severity of the anxiety disorder.

Bibliography

Bongiorno, Peter. Holistic Solutions for Anxiety & Depression: Combining Natural Remedies with Conventional Care. New York: Norton, 2014. Print.

Charney, D. S., S. B. Nemeroff, and S. Braun. The Peace of Mind Prescription: An Authoritative Guide to Finding the Most Effective Treatment for Anxiety and Depression. Boston: Houghton Mifflin, 2004. Print.

Colman, I., et al. “Psychiatric Outcomes Ten Years After Treatment with Antidepressants or Anxiolytics.” British Journal of Psychiatry 193 (2008): 327–31. Print.

National Institute of Mental Health. “Medications.” Bethesda: Author, 2002. Print.

Newman, M. G., and W. B. Stiles. “Therapeutic Factors in Treating Anxiety Disorders.” Journal of Clinical Psychology 62 (2006): 649–59. Print.

Pillay, N. S., and D. J. Stein. “Emerging Anxiolytics.” Expert Opinion on Emerging Drugs 12 (2007): 541–54. Print.

Swartz, Karen L. Depression and Anxiety: Your Annual Guide to Prevention, Diagnosis, and Treatment. Baltimore: Johns Hopkins Medicine, 2013. Print.

Tone, Andrea. The Age of Anxiety: A History of America's Turbulent Affair with Tranquilizers. New York: Basic Books, 2011. Print.

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