Anxiolytics, an overview

By Cristiano Antonino On Apr 20, 2023

Anxiolytics are among the most common drugs for the ambulance crew: they are often among the prescriptions of the patient’s attending physician

In some cases they are administered as an emergency, to alleviate the effects of a series of pathologies that determine a clinical picture.

It is therefore useful to take an overview of this category of drugs.

Anxiolytics are medications that can treat anxiety and related conditions

Because so many medications have this effect, this includes many different medications across several types. They’re among the most commonly prescribed medications worldwide.

What are anxiolytics?

Anxiolytics are medications that can treat anxiety symptoms.

Medications with this effect span several different drug classes, including medications that mainly treat other conditions.

“Anxiolytic” combines two root words from ancient Greek, “anxio-” meaning “anxiety” and “-lytic,” meaning “to loosen.”

These medications “loosen” anxiety’s hold on you. Some experts also refer to them as “anti-anxiety” medications.

Types of anxiolytics

Many different types of drugs have anxiolytic effects.

These include:

Antidepressants.
Antihistamines.
Azapirones.
Barbiturates (no longer used for anxiety).
Benzodiazepines.
Beta-blockers.
Nonbenzodiazepines (also known as Z-drugs).
Sedative-hypnotics.

How do anxiolytics work?

Because there are so many different types of anxiolytics, there are also multiple ways that reduce anxiety.

These ways break down into a few different categories:

Increase cell activity: Some drugs tell certain cells to activate. Benzodiazepines, nonbenzodiazepines and barbiturates are examples of this. They activate a process that makes your body release gamma-aminobutyric acid (GABA), a neurotransmitter your body uses to reduce nervous system activity, which helps anxiety.
Decrease cell activity: Beta-blockers are an example of this, slowing down activity in your sympathetic nervous system (the system that manages your “fight-or-flight” response).
Slow reabsorption of neurotransmitters: Some drugs keep your body from reabsorbing certain neurotransmitters. That means you have more of those neurotransmitters available. Antidepressants have this effect on neurotransmitters like serotonin and norepinephrine.
Some medications can have multiple effects. The azapirone drug buspirone and the antihistamine drug hydroxyzine are examples of this. They can increase activity in certain cells and decrease it in others.

What conditions do anxiolytics treat?

Anxiolytics treat anxiety disorders, which include several conditions.

They can also treat conditions that have similarities to anxiety disorders.

The possible conditions that may involve anxiolytics as treatment include (but aren’t limited to) the following:

Generalized anxiety disorder.
Panic disorder.
Specific phobia.
Agoraphobia.
Posttraumatic stress disorder (PTSD).

Some drugs with anxiolytic effects mainly treat other conditions but also see “off-label” use for anxiety.

Off-label prescribing is a legal practice where healthcare providers prescribe drugs for reasons other than the approved use.

This is medically acceptable and justified if the drug has a known helpful effect and a low risk of harmful side effects.

Beta-blockers are an example of this.

They mainly treat heart and circulatory issues, but providers often prescribe them off-label for certain types of anxiety.

Are anxiolytics commonly prescribed?

Anxiety is a common condition, meaning, anxiolytic drugs are among the most commonly prescribed medications worldwide.

Additionally, medications with anxiolytic effects are common in treating other conditions.

What are the potential benefits of anxiolytics?

There are many potential advantages and benefits to anxiolytics.

Anxiety is a common condition, so anxiolytics have been a part or focus of study and research for decades.

That means healthcare providers have a greater understanding of prescribing and using them safely and effectively.

Variety of medications and medication types

One of the biggest advantages of anxiolytic medications is that so many different drugs have this effect.

That means if one drug doesn’t work, there are other options.

It may take some trial and error, but generally, it’s possible to find a medication or combination of medications that work for you.

Contributions to other treatment approaches

Anxiolytics can also make other types of mental health treatments for anxiety more effective.

When used together, anxiolytics and mental health therapy (the technical term is “psychotherapy”) typically have a much higher success rate for managing anxiety and related mental health conditions.

Potential to improve quality of life and well-being

It’s also beneficial to treat anxiety in general.

Anxiety is a condition that can greatly disrupt your life and reduce your quality of life.

Having anxiety can disrupt your ability to work, have relationships, or just get a good night’s sleep.

Anxiety can also be a factor that contributes to several other chronic conditions, including (but not limited to) the following:

Alzheimer’s disease.
Chronic obstructive pulmonary disease (COPD).
Cognitive impairment and dementia.
Depression.
Diabetes.
Heart attack and heart disease.
Hyperthyroidism.
Parkinson’s disease.
Stroke.

Because of this, treating anxiety is a very important part of restoring and maintaining your overall physical and mental health and well-being.

What are the possible disadvantages, side effects and complications of anxiolytics?

Depending on the medication(s) you take, anxiolytics can have side effects, complications or possible drawbacks.

Some of these include:

Variable effectiveness: No two people are exactly alike when it comes to how a medication affects them. Some people may get good results from one, and others won’t get any benefit from it. That can sometimes mean it’ll take a little longer to find a drug that helps you.
Addiction potential: Some anxiolytics have no prescription restrictions. Others are — depending on your location — tightly controlled and regulated. Benzodiazepines and nonbenzodiazepines, which can be habit-forming, have the potential for misuse and carry a risk of overdose. For those reasons, some anxiolytics are only recommended for short-term use.
Interactions: Anxiolytics can affect many body systems, not just your nervous system. The potential for interactions can vary widely depending on the medication(s) you take. Many of these drugs also interact with alcohol, so if you take certain anxiolytics, drinking alcohol is either not recommended, dangerous or both. You should also talk to your healthcare provider about the supplements you take (especially before you start taking them) to be sure they don’t interact with your medications.
Side effects: Anxiolytics often make you tired, sleepy or otherwise slow your reaction times. That may mean driving, operating machinery or engaging in other activities while you take them is unsafe. Other anxiolytics, such as beta-blockers, can also affect other organs like your heart. Because of that, your provider may recommend avoiding certain anxiolytic drugs.
There are other possible drawbacks to anxiolytics. Your healthcare provider can tell you more about the possible concerns you might face. The information they provide will be the most relevant to your situation. They can also tell you what you can do to minimize or avoid possible problems.