Anxiolytics: be vigilant!

Prescribed against anxiety, anxiolytics (especially benzodiazepines) remain over-consumed in USA. The risk of dependence is nonetheless significant. Focus on these psychotropic drugs.

Anxiolytics are psychotropic drugs, so named because they act on the level of brain chemistry. Minor tranquilizers, they serve to pass a course, to lessen the anxious pressure that stifles the patient.

What is the use of anxiolytics?

It is first to relieve his symptoms, and then to allow him to take the reins of his psyche. These drugs provide valuable help to overcome a test, but they do not cure anxiety on the merits.

Their prescription must therefore be limited to twelve weeks. It is intended primarily for people who are prone to acute anxiety attacks, and only secondarily for those with a chronic anxiety disorder.

For anxieties that cannot be resolved during this time, a relay must be engaged with other therapies. Depending on the case, it may be an antidepressant treatment, a cognitive and behavioral therapy, a psychotherapy, relaxation methods.

Benzodiazepine anxiolytics

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Most anxiolytics belong to the category of benzodiazepines, widely used for their almost immediate effect. They reduce communication between certain nerve cells, which reduces anxiety, improves sleep and relaxes muscles.

Among the benzodiapines most prescribed in anxiety, we find bromazepam (Lexomil), prazepam (Lysanxia), lorazepam (Temesta), clorazepate (Tranxene) diazepam (Valium). These molecules are also prescribed in generics with exactly the same action. Derived closely, estifoxine (Stresam) may be prescribed in the psychosomatic manifestations of anxiety, but its rare but serious adverse effects have led to limit its prescription.

Some antidepressants are prescribed as anxiolytics, obsessive compulsive disorder or phobias.

Non-benzodiazepine anxiolytics

Among the non-benzodiazepine anxiolytics: hydroxyzine (Atarax) which is originally an antihistamine molecule (against allergy).

This list of medicines is not exhaustive, only the prescribing doctor is authorized to determine the prescription adapted to each case.

What are the side effects of anxiolytics?

Less sedative than sleeping pills (or hypnotics), benzodiazepine anxiolytics induce drowsiness, more or less marked by individuals, which leads to strongly discourages driving or any risky maneuver (at the factory). There are also disturbances of balance and memory for all patients, especially the elderly who have an increased risk of falls.

As with sleeping pills and certain anti-depressants, prolonged use of anxiolytics leads to habituation (efficacy decreases and dose needs to be increased to achieve the desired therapeutic effect) and dependence (discontinuation of the drug causes painful withdrawal syndrome, which makes consumption resume).

Hydroxyzine (Atarax) has among its side effects a dry mouth, constipation, a risk of blockage of the urine (especially in case of prostate adenoma) and glaucoma, an eye disorder (difficulties of accommodation, sensitivity to light), disturbances of balance in the elderly, but an absence of dependence.

The combination of all anxiolytics with alcohol is formally contrindicated.

Anxiolytics: succeed in stopping

When the addiction is established, usually after several months, the abrupt cessation of the drugs causes a syndrome of withdrawal: major disorders of sleep with agitation and nightmares (important cause of failure of the weaning), headaches, muscular pains and weakness, rebound of pronounced anxiety, irritability, agitation, tremors, anorexia, nausea, sweating, diarrhea.

Two slogans for a successful weaning: the stop must always be progressive and under medical control. Depending on the nature of the molecule and the dosages usually taken by the patient, the doctor will be led to prescribe a replacement molecule and / or to lower the dosages very gradually.