Anxiety is defined as an involuntary anticipatory response of the organism to external or internal stimulisuch as thoughts, ideas, images and other concepts that are perceived by the patient as threatening or dangerous. This is a psychological event that often manifests itself somatically, with palpitations, hyperventilation, gastrointestinal problems, sweating, tremors and much more.
Sporadic anxiety is normal, even more so when we coexist in a society that demands of us a vital rhythm that is perhaps too accelerated for most people. However, when the symptoms persist over time and make the patient’s existence difficult, generalized anxiety disorder (GAD) is suspected. The prevalence of this condition is 5%, although it is estimated that there are many more people suffering from it than the data suggests.
It is at this point when it is time to ask for psychological help. Feeling anxious momentarily is normal, but living with anxiety is a chronic and debilitating condition that must be treated.. If you have decided to put yourself in the hands of a psychologist and a psychiatrist after your diagnosis, we recommend that you continue reading, because today we present the 6 types of anxiolytics on the market.
What are the most commonly used types of anxiolytics?
An anxiolytic is a psychotropic drug with central nervous system depressant action.Its function is to reduce the symptoms of anxiety and anguish in the patient (without the need for this to be accompanied by sedation or sleep). In support of this category, we find antidepressants and beta-blockers, since the only anxiolytics per se are those that act in a targeted manner against the symptoms of anxiety (anti-anxiety).
Beyond this classification system and medical terminology, we are going to focus on drugs that help patients with prolonged anxiety over time or with notorious crises, regardless of whether the drug was created for that sole purpose or whether it is able to alleviate symptoms in an ancillary way. Let’s get down to it.
1. Barbiturates
They are a family of drugs derived from barbituric acid (as the name suggests) that act as central nervous system sedatives, producing a wide range of effects, from mild sedation to a state of total anesthesia.
They are effective as analgesic, anxiolytic, hypnotic and anticonvulsant drugs.. However, they have been substituted for benzodiazepines in daily medical practice, as they are extremely addictive. Moreover, in reasonably low doses barbiturates can make the patient appear drunk or intoxicated, so they are not very useful if the patient intends to lead a normal life.
2. Benzodiazepines
The current queens of anxiety treatment. Benzodiazepines are psychotropic drugs with relaxing, sedative, hypnotic, anticonvulsant, amnesic and muscle relaxant effects. They are central nervous system depressants that are more specific than barbiturates, since they precisely enhance the inhibitory action mediated by GABA, a neurotransmitter that transmits a message of inhibition to the neurons, with which it comes into contact so that they slow down their impulses or stop transmitting them.
Benzodiazepines are safe drugs to use, but they have a clear problem: they should only be taken continuously for periods of 2 to 3 months at the most, as they are addictive. Benzodiazepines are used regularly as anxiolytics by 12.5% of Americans, but up to 2% of patients do not use them correctly. Xanax and diazepam abuse is a real problem in this country, with a not inconsiderable percentage of the population using them recreationally and irresponsibly.
Some of the commonly abused benzodiazepines are as follows: alprazolam, bromazepam, clonazepam, diazepam, triazolam and flurazepam. Their uses are relatively different, always based on the patient’s requirements, so they are only sold under prescription and after prior consultation with a professional.
3. Carbamates
Carbamates are organic compounds derived from carbamic acid. We are talking more specifically about meprobamate, a member of the chemical class of propanediols, quite similar to the previously mentioned barbiturates.
Again, these drugs have fallen into oblivion since the discovery and standardization of the use of benzodiazepines. Meprobamate causes very dangerous interactions with alcohol, only relieves anxiety in the short term, has a limited range of action and is also quite addictive. It is therefore no longer prescribed today..
4. Antihistamines
Antihistamines are drugs that primarily serve to reduce or eliminate the effects produced by allergies, as they block the release of histamine, a substance clearly linked to the local responses of the immune system.
Hydroxyzine is a first generation antihistamine drug with sedative, anxiolytic and antiemetic (nausea control) effects. Unlike carbamates and barbiturates, hydroxyzine has been shown to be about as useful for anxiety disorders as benzodiazepines and, in addition, causes fewer side effects. It is marketed under the pharmaceutical name “Atarax” and is very useful in treating prolonged anxiety, as well as addressing allergic itching and hives.
5. Opioids
Opioids are substances very similar to morphine (an opioid) in that, when they reach the relevant receptors, they greatly reduce symptomatic pain in patients and induce anesthesia. Because of the multiple side effects they can bring and the high addiction they cause, these drugs are used sporadically to relieve pain in surgical patients and in people with aggressive cancers, who cannot otherwise manage their chronic discomfort.
Despite their historical association with pain relief, new research suggests that opioids may help in the treatment of depression. may help in the treatment of depression, obsessive-compulsiveobsessive-compulsive disorders and other conditions related to chronic anxiety. In any case, they have one of the highest addiction rates of all the drugs described here: for this reason, we doubt that they will ever be viable treatments for anxiety, at least in their current forms.
6. Antidepressants
Antidepressants are the first-line treatments to address long-term anxiety in patients. To give you an idea, benzodiazepines are used in critical moments on an emotional level (recent loss, constant anguish, discomfort derived from a specific event), whereas antidepressants are the “cushion” for the long termThey are prescribed for a minimum duration of 6 months to 2 years, with the option of prolonging the treatment.
This group includes selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors. Some of the most commonly used are: lexapro, cymbalta, effexor XR, paxil and many others.
However necessary they may be in many cases, they are necessary in many cases, but they do have side effectsSome patients experience nausea, weight gain and sleep problems, but these events usually resolve within a few weeks of starting treatment. Unfortunately, others experience clinical signs throughout the treatment, lack of libido being one of the most common (in 30-60% of cases).
In any case, it should be noted that antidepressants do not generate the same addictive effect as barbiturates, benzodiazepines, carbamates and opioids. They do not act quickly, do not cause withdrawal syndrome and it is not necessary to increase the doses to fulfill their function. Despite their low danger on this front, this does not mean that the patient cannot psychologically associate these drugs with their well-being and will not want to stop taking them: therefore, stopping the use of antidepressants is always a slow and gradual process.
Summary
You may have heard this many times before, but if it is said, it is for a reason: pharmacological treatment without a simultaneous psychological approach is of little use.. The use of medication should not last forever and, therefore, the patient must acquire the necessary tools to cope with his or her anxiety while being treated “chemically”. If the necessary psychological support is not received, it is possible that after stopping the medication the person may return to square one, perhaps with a tendency to addiction due to the drugs taken.
Therefore, we strongly recommend that you do not rely solely on pills if you have a generalized anxiety condition. The psychologist will help you manage your emotional crises, nip cyclical thoughts in the bud and try to bring peace to your life in the face of feelings of excessive worry, hypochondria, lack of self-esteem and many other events associated with anxiety. Remember that knowing how to control your mind is as important as controlling your body, so in these cases it is necessary to go beyond pharmacology.
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