Anxiolytic

Anxiolytic literally means fear (on ) solver. Are used interchangeably, the terms Ataraktikum ( " downer" ) or minor tranquilizer (English for "weak sedative "). Describes drugs that can be used for anxiolysis, so to reduce excessive or pathological anxiety. The main group of anxiolytics are the benzodiazepines, showing its significant side effect of targeted abuse and possibly rapid and partly strong development of addiction. In Germany therefore substitute prescribed rather anxiolytics other drug classes.

Drug groups

Benzodiazepines

Benzodiazepines are effective drugs with rapid onset of action. Although their side effect profile is more generally uncritical, is with them always the danger of a rapid and sometimes very strong development of addiction. Benzodiazepines are therefore used only usually short-term, such as the treatment of panic disorder, or as a rescue medication for severe mental underlying diseases. Another problem with the use of benzodiazepines are Rebound at weaning after prolonged dosing.

The benzodiazepines include:

  • Lorazepam
  • Diazepam
  • Alprazolam
  • Clonazepam
  • Oxazepam
  • Midazolam

H1 - antihistamines

Some older first-generation antihistamines ( histamine H1 - receptor antagonists) also have sedative or anxiolytic effects and are used for these purposes. They are distinguished, as well as the benzodiazepines, by a rapid onset of action, but without the risk of physical addiction development. However, show sedating antihistamines over the benzodiazepines something worse side effect profile due to their pronounced anticholinergic effects. Therefore, the use of this drug class for seniors over 65 years by some authors critically assessed. The best-known drug of this group is hydroxyzine.

Antidepressants

Are often used for long-term treatment for anxiety disorders antidepressants. These require several weeks of use, until they show sufficient efficacy. For short-term treatment or for spot application of panic attacks they are therefore unsuitable. A distinction is made in the older tricyclic antidepressants drugs and the more modern selective serotonin reuptake inhibitors. These antidepressants typically have no physical addiction potential, however, the so-called SSRI Absetzsyndrom may occur.

Neuroleptics

So-called low-potency neuroleptics can also be used for anxiolysis. These agents are in anxiety disorders due to their potential side effects normally as second choice. However, they can be agents of first choice for severe anxiety symptoms in the context of severe mental or physical illness. Known anxiolytic substances from this group, promethazine, and melperone pipamperone.

Other drugs

In anxiety disorders further be used:

  • Buspirone - onset of action after a few weeks. Physical addiction in the literature are not described.
  • Opipramol - onset of action after a few days. Physical addiction unlikely but possible withdrawal reactions possible after long-term and / or high-dose ingestion.
  • Pregabalin - Rapid onset of action after a few days. Physical addiction potential likely extent hitherto unknown.

Herbal medicines

Herbal medicine and folk medicine also knows some anxiolytic substances. These include, among others:

  • Valerian
  • Lavender
  • Kava Kava ​​(in Germany not permitted because of side effects on the liver )
  • Passionflower
  • Chamomile
  • St. John's Wort
Benzodiazepine dependence
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