Anxiolytics

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Anxiolytics

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Xanax, Valium, Librium

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Anxiolytics

Anxiety is one of the most common mental health disorders to date.  Everyday, sufferers experience symptoms of anxiety such as feelings of impending doom, fear, panic, heart palpitations, difficulty breathing, and dizziness.  Without the proper medication, anxiety can range from discomfort to debilitating, to the need to close oneself off from the rest of the world.  For those that suffer from anxiety, anti-anxiety medication or (Anxiolytics) can provide a significant increase in quality of life.

Why Is Anxiety So Common? 

Although there isn’t a definitive answer to this question, we can agree that mental illness such as anxiety and depression are very common. Societal pressures, along with the individualistic nature of our culture can put great stress on many, but we must also keep in mind the biological factors of anxiety as well.  More people today however are admitting to suffering from anxiety or depression than in the past, this may be contributed to an effort in reducing the stigma of mental illness. Even celebrities are coming out with their own personal stories of emotional or mental struggles in hopes of reaching out to others that can relate to their malaise.

What Are Anxiolytics?

Anxiolytics is a group of prescription medication used to reduce anxiety and symptoms of anxiety disorders such as Generalized Anxiety Disorders, Social Phobia, Obsessive Compulsive Disorder and Panic Disorders to name just a few. The two most common classes of anxiolytics are Benzodiazepines and SSRI’s, (Selective Serotonin Reuptake Inhibitors). Anxiolytics have a good success rate in fighting what can sometimes be debilitating symptoms for those that suffer from anxiety.

Benzodiazepines

Also known as chlordiazepoxide (librium) and diazepam (valium), Ativan, Halcion, Restoril and Xanax all promote sleep and relaxation to muscles.  This class of anxiolytics is a GABA agonist, and decreases excitation of the nervous system by increasing the affinity of GABA or (gamma-aminobutyric acid) (which is a major inhibitory neurotransmitter) synthesized from Glutamate – (which is the major excitatory neurotransmitter) to keep the nervous system balanced.  Benzodiazepines work on the central nervous system by opening GABA activated chloride channels allowing chloride ions to enter the neuron which will increase the efficiency of the receptors and in turn provide an inhibitory effect of the neurons, slowing down the nervous system.

Benzodiazepines are the distinguished ‘go-to’ drugs of today for anxiety.  They are behavioral depressants which are largely prescribed by doctors to treat not only anxiety, but also muscle spasms and sleep disorders.  Compared to traditional Barbiturates, Benzodiazepines are considered to be relatively safe.  So much so that doctors began overprescribing them resulting in long term usage and heavy addiction comparable to that of heroin addiction, and it has been discovered that withdrawal symptoms from Benzodiazepines can last up to two years.

Benzodiazepines can work in three manners ranging from short, intermediate and long lasting effects.  For long-term anxiety disorders, the long acting benzodiazepines tend to be more consistently successful for treatment.  For faster results in conditions such as insomnia, the short duration benzodiazepines such as Xanax are more successful.  They have a shorter ½ life, but the results are more immediate resulting in sleep and relaxation almost immediately.  The ½ life of a drug refers to the length of time it takes for the concentration of the drug within the body to decrease by half.  If you are being treated for generalized anxiety disorder for example, then a slower and longer lasting half-life such as diazepam (or Valium) would be more suitable, as the effects will last into the following day and quite possibly until the next required dose. Common side effects of Benzodiazepines are drowsiness, confusion, dizziness, blurred vision, weakness, slurred speech, difficulty breathing, lack of coordination, slow psychomotor skills, memory impairment, and depression.

List of Benzodiazepines

 SSRI’s – Selective Serotonin Reuptake Inhibitors

Also known as Serotonin Agonists, SSRI’s are used to treat anxiety as well as depression. This class of drugs mimic the activity of the neurotransmitter serotonin when it appears to be deficient, (or reverses the defect of the neurotransmitter), without causing sedation and muscle relaxation. SSRI’s delay the re-absorption of serotonin and thus increases the levels resulting in positive mood, behavior and treatment in symptoms of depression, as low serotonin levels can result in depressive symptoms.  Side effects of SSRI’s can be drowsiness, nausea, dry mouth, insomnia, diarrhea, agitation, dizziness, sexual dysfunction or difficulties.

List of SSRI’s

  • Citalopram (Celexa)
  • Escitalopram (Lexapro, Cipralex)
  • Paroxetine (Paxil, Seroxat)
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Sertraline (Zoloft, Lustral)

Who Uses Them?

As anxiolytics have been the most commonly prescribed drug by doctors to date, it’s no surprise that they are widely used by many.  Women 45 years and older have the highest rate of use, while men between the ages of 20 – 40 years have shown a significant increase in usage rate rising 43% from 2001 to 2010.  Those that are unemployed and seniors also have an increasing rate of usage.  

Addiction

Addiction is possible with long term use of benzodiazepines and it is not recommended to be used for longer than 4 weeks.  Symptoms of benzodiazepine addiction can be dry retching, psychosis and hallucinations as well as a paradoxical effect (meaning it has the opposite effect of the intended purpose of the drug)

Benzodiazepines can be abused by misuse.  When used with other drugs such as alcohol, it is easier to form an addiction to this class of drugs, as well; taking benzodiazepines with alcohol can especially lead to fatal consequences. 

Withdrawal

Withdrawal symptoms from Benzodiazepines range from further anxiety, tremors, muscle spasms, nausea, stomach pain, moodiness, confusion, hallucinations, violent tendencies, depression and seizures, and acute withdrawal can also be fatal.  It is always important to withdraw from Benzodiazepines under the instruction and supervision of a medical professional. 

SSRI’s have not been found to be addictive; however caution must be taken during withdrawal as it can cause addictive type symptoms.

Benefits

There can be positive benefits with correctly prescribed and administered anxiolytics in those that require them.  Individuals suffering from anxiety can feel as though they’ve had their lives returned to them, relative to the stark contrast from their prior existence.  Anxiety can be a debilitating disorder, and anxiolytics can help them function in society rather than suffering or hiding away on a daily basis.

 Controversy

Some patients tend to have reservations in taking anti-anxiety medication for fear of addiction and other health risks, usage in teens can also result in an increase in suicidal ideation, and usage in seniors carries a risk of stronger adverse side effects. 

Doctors also tend to prescribe these medications without proper supervision or follow-up.

Conclusion

Anxiolytics, although can harvest reservations in some, are also responsible for improving quality of life and personal function within society for those who suffer from anxiety disorders or acute anxiety situations.  With the proper supervision, continual follow-up and correctly following prescription instructions, anti-anxiety medication can be very beneficial to those who need it.

Sources:

  1. http://www.healthline.com/health/anxiolytics
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  3. https://www.ncbi.nlm.nih.gov/pubmed/6134609
  4. http://www.medscape.com/viewarticle/706336_3
  5. http://apps.who.int/medicinedocs/documents/s19032en/s19032en.pdf
  6. https://www.psychologytoday.com/blog/our-changing-culture/201410/why-so-      many-people-are-stressed-and-depressed
  7. http://mentalhealthdaily.com/2014/10/24/anti-anxiety-medication-list-anxiolytics/
  8. https://www.addictionhope.com/benzodiazepine/
  9. http://www.tandfonline.com/doi/pdf/10.1080/20786204.2010.10873947
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  12. Liska, Ken. (2009).Drugs and the Human Body, With Implications for Society. (8th Edition). Upper Saddle River, NJ. Pearson, Prentice Hall
  13. Small, Cathleen. (2015).Valium and other Anti-Anxiety Drugs. NY. Cavendish Square Publishing

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