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Anxiolytic

 

Anxiolytic

An anxiolytic is any drug used in the treatment of anxiety. Azapirones, benzodiazepines, barbiturates, meprobamate and non-cardioselective beta-receptor blockers can be prescribed. For somatic symptoms propranolol and oxprenolol can be used.

Azapirones, such as buspirone, are most commonly prescribed. They are chemically and pharmacologically quite different from most of the other anxiolytics and the adverse effects of dependence, sedation, and psychomotor impairment are noticeably less than with benzodiazepines.

Benzodiazepines are prescribed for short-term relief (the FDA recommended maximum of 8 months for most benzodiazpeines) of severe and disabling anxiety. Common medications are Valium® (diazepam) and Xanax® (alprazolam). They are used to treat a wide variety of conditions and symptoms, and are usually a first choice when short-term CNS sedation is needed. Longer term uses include severe anxiety and psychosis. There is a risk of withdrawal symptoms and rebound syndrome after only a few weeks. There is also the added problem of the accumulation of drug metabolites and adverse effects.

Certain herbs, such as St. John's Wort, have been used as anxiolytics, but little reliable evidence is available for their efficacy. St. John's Wort is generally thought to be a mild selective serotonin reuptake inhibitor, or SSRI, like the prescription medications Prozac® (fluoxetine) and Paxil® (paroxetine).



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