What are the Different Types of Anxiolytics?

Christina Hall

Anti-anxiety medications, or anxiolytics, are varied in their method of action. Most drugs used to treat anxiety conditions work on the balance of chemicals in the brain and can either alter or inhibit the amount or action of a targeted neurotransmitter. Some types of these anxiolytic drugs include benzodiazepines, serotonin selective reuptake inhibitors (SSRIs), and azapirones. Barbiturates, which are extremely strong tranquilizers, are included in the group as well, but are rarely prescribed because of their large side effect profile and overdose potential. Other drugs, like beta blockers, are used as anxiolytics because they inhibit some of the major physical manifestations of anxiety and panic, such as rapid heartbeat and sweating that are experienced with an overactive “fight or flight” response.

Unlike antidepressants, benzodiazepines provide fast-acting relief for anxiety symptoms.
Unlike antidepressants, benzodiazepines provide fast-acting relief for anxiety symptoms.

Benzodiazepines have become some of the most commonly-prescribed anti-anxiety medications. The drugs in this category work to encourage the functioning of the gamma-Aminobutyric acid (GABA) system in the brain. GABA is an inhibitory neurotransmitter needed to slow down the stress response, and treatment with a benzodiazepine drug ensures that GABA receptors are adequately activated. Benzodiazepines work well because they are fast-acting and carry a low side effect profile, but tolerance, dependence, and withdrawal risk deters many clinicians from prescribing them for long periods of time. Some commonly-prescribed benzodiazepine anxiolytics include alprazolam, clonazepam, and diazepam.

Anxiolytic drugs are used to treat different forms of anxiety.
Anxiolytic drugs are used to treat different forms of anxiety.

SSRIs, like sertraline HCl and paroxetine hydrochloride, are often prescribed as long-term treatment options for anxiety disorders. They carry significantly less abuse risk and have been proven in clinical trials to be effective as anxiolytics. SSRIs, as well as related antidepressants, work by blocking the reuptake of serotonin, which increases the amount of the substance available in the synapse, which then helps balance the chemical ratio in the brain. When the brain reaches a point of homeostasis during treatment with SSRIs, anxiety and worry are significantly decreased. One of the most glaring disadvantages to treatment with this type of medication is the time it takes for the drug to build up to pharmacologically active levels in the system, which is sometimes up to two months.

An anxiety disorder is an intrusive mindset of obsessive thoughts or flashbacks coupled with varying physical symptoms of fear.
An anxiety disorder is an intrusive mindset of obsessive thoughts or flashbacks coupled with varying physical symptoms of fear.

Azapirones, like buspirone, are a newer type of anxiolytic. They work in much the same way as an SSRI, but they address anxiety more thoroughly by not only increasing serotonin, but regulating dopamine uptake as well. The mechanism of azapirones is not fully understood, but many researchers agree that its effectiveness might also be due to a correlation with GABAergic pathways in the brain.

Paroxetine and other SSRIs are frequently prescribed as a long-term option for dealing with anxiety disorders.
Paroxetine and other SSRIs are frequently prescribed as a long-term option for dealing with anxiety disorders.
Like anti-anxiety medications, exercise can help relieve anxiety.
Like anti-anxiety medications, exercise can help relieve anxiety.
Patients who take an anxiolytic should not discontinue its use without consulting a physician.
Patients who take an anxiolytic should not discontinue its use without consulting a physician.
Benzodiazepines belong to a group of drugs called tranquilizers that may be prescribed for anxiety.
Benzodiazepines belong to a group of drugs called tranquilizers that may be prescribed for anxiety.
Side effects of sertraline may include insomnia.
Side effects of sertraline may include insomnia.

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Discussion Comments

anon325456

If you truly suffer from the "real deal" of panic disorder/anxiety attacks, you are wasting your time with garbage like therapy and SSRIs. While these things may help in other areas of psychological problems, panic attacks are lifetime deals that must be treated medically. And yes, when you have one you think you are going to literally die!

cahall

Anxiety disorders are often downplayed as the person is just a "worrier" or just isn't tough enough to deal with everyday stressors. In my opinion, chemical imbalance can be inherent and also made worse by years of avoidant and self-esteem issues.

Again, in my opinion, benzos should be used as a last resort; the rebound anxiety and withdrawal can literally hospitalize a patient. SSRIs can work for some, but med compliance is hard when the medication tends to make the symptoms worse before they get better.

Listen to your doctor (if you trust them) and be sure to get some CBT (says the girl who is afraid to go to a therapist).

pleonasm

@Iluviaporos - I think the resistance to using drugs to treat anxiety often comes from the patient herself, rather than from others.

Some anxiolytic side effects can include things which might seem like they are interfering with or changing a person's personality. And while they want to live without anxiety, they also don't want to be a different person. I understand that impulse perfectly.

Which is why I think that those kinds of drugs should be a last resort. Beta blockers don't do anything to change your personality, they just block the physical response to anxiety and using those, coupled with counseling, can help a great deal before other anti anxiety medicine needs to be considered.

lluviaporos

Anxiety is one of those mental health issues that people don't tend to take very seriously. But, it is a serious problem in those who suffer from it. It can make it impossible to function in society and lead to people being withdrawn and feeling isolated. Plus, it can have unpleasant side effects, like panic attacks, where you really do feel like you are dying.

I think there are quite a few people who think that medication is a step to far when it comes to this kind of thing, but they probably have never experienced a real anxiety disorder. It can disrupt your entire life and the lives of those who love you.

If anxiolytic medications can make a difference to it, I say, more power to them.

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