Anxiolytic drugs belong to several classes, including benzodiazepines and antidepressants. Other drug types that may have anxiety-relieving properties are beta-blockers and antihistamines. The patient’s condition and response to medications may determine which drug classes physicians are likely to consider. None of these medications can cure anxiety disorders.
Benzodiazepines are fast acting and can relieve nervousness or panic within a few hours of use. Examples of these drugs are diazepam, alprazolam, lorazepam and clonazepam. These medications all act on GABA receptors and influence the way the brain processes anxiety. They promote calm, but have side effects such as sedation. Regular use tends to build tolerance and dependence, and these medications are notoriously abused.
Certain antidepressants are considered useful anxiolytic drugs. Many of the selective serotonin reuptake inhibitors (SSRIs) and the serotonin norepinephrine reuptake inhibitors (SNRIs) are regularly prescribed to treat anxiety disorders. A few other antidepressants can help treat anxiety, like the atypical buspirone. Some tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) are suggested for anxiety treatment, too.
Using antidepressants to treat long-term anxiety has an inherent logic. Depression and anxiety are often thought to result from similar chemical processes, and are considered very related in function. The disadvantage of most antidepressants is that they aren’t fast acting and must be used daily. Also, these drugs can take up to six weeks to become fully effective, and not all patients respond favorably to them.
Other anxiolytic drugs come from the beta-blocker class. Atenolol and propanolol are common choices. They especially address the physical symptoms of anxiety like sweaty palms, shaking, and rapid breathing. Neither drug appears to have much effect on the emotional turmoil that arises with panic.
An additional group of drugs used for anxiety that tend to result in sedation are antihistamines. Even an over-the-counter drug like diphenhydramine might be considered for its anxiety-fighting properties. Like benzodiazepines, these drugs work swiftly. On the other hand, both classes of medications may become less effective with regular use.
A patient’s condition partly determines the best anxiolytic drugs and classes. Both benzodiazepines and antidepressants are regularly used in the treatment of generalized anxiety disorder, panic disorder, post-traumatic stress syndrome, and obsessive-compulsive disorder. Bipolar disorders tend to be associated with higher levels of anxiety, but antidepressants may cause mania in people with this condition. Benzodiazepines might pose a solution, and antipsychotic drugs like quetiapine could also be considered for treating anxiety in bipolar patients.
People with social anxiety might be treated with either antidepressants or beta-blockers. When patients are particularly concerned that their nervous feelings may “show,” beta-blockers could be the best choice. Antihistamines are usually a last resort for treating anxiety disorders, but patients who are not responding to other medications might try them.
Reducing anxiety with anxiolytic drugs promotes patient comfort. Medication is only a part of treatment for anxiety; psychotherapy should also be included as it is potentially curative. Use of anxiolytic drugs should be thought of as a helpful add-on to therapy, instead of as a long-term solution to the problem.