Anxiolytics

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. In the United States alone, tens of millions of people have prescriptions to treat anxiety. 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.

Research and study history

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.

How long can I stay on anxiolytics?

The length of time you can stay on an anxiolytic depends on many factors. The specific drug you take, the type of anxiety you experience, your health history, personal preferences and more can all affect this.

Some anxiolytics are meant for short-term use only. Others, you can take indefinitely. Your healthcare provider is the best person to tell you this answer and can help you understand your options.

Can I work or drive if I’m taking anxiolytics?

Many anxiolytics won’t interfere with your ability to drive or work. Some, such as benzodiazepines and nonbenzodiazepines, may make you sleepy. If you take these drugs, you should talk to your provider before you drive or work after taking them. Your provider can help you determine if it’s safe for you to engage in certain activities when these drugs are active. They can also help you find a schedule and dosage that causes minimal or no disruptions in your daily life, routine and activities.

When should I call my healthcare provider?

Anxiety is a condition that can severely undermine your mental health and well-being. Because of that, it can increase the risk of self-harm or suicidal thoughts and behaviors. Some medications, especially antidepressants, can also contribute to suicidal thoughts or behaviors unexpectedly.

You should get immediate help if you have thoughts about harming yourself or others, or if you suspect someone you know is in danger of harming themselves. Resources that can help include:

• National Suicide and Crisis Lifeline (United States). This line can help you if you have suicidal thoughts or impulses. You can also call this line even when you’re not in crisis. To call this line, dial 988. You can also get help via text message. To do so, text HELLO to 741741.
• 911 (or your local emergency services number). You should call 911 (or the local emergency services number) if you feel like you are (or someone you know is) in immediate danger of self-harm or suicide. Operators and dispatchers for 911 lines can often help people in immediate danger because of a severe mental crisis and send first responders to assist.

What is the best anxiolytic drug?

Unfortunately, there’s no simple answer to that question. What works for one person may not work for another. Some anxiolytic drugs are good for short-term use only, while you can take others for years (or even indefinitely). Your healthcare provider can tell you more about your options and help you find the best anxiolytic drug for you.

A note from Cleveland Clinic

Anxiety is a very common mental health condition that can also cause major negative effects on your life. Fortunately, there are many drugs with anxiolytic (antianxiety) properties. These drugs can’t cure anxiety but can treat it and help you manage its effects.

If you experience anxiety, it’s a good idea to talk to your healthcare provider. Seeking help for mental health concerns like anxiety isn’t a sign of weakness. These concerns are very common, and seeking help can give you a chance to focus on the things you care about most in life, rather than the things you worry about most.