Talk:Anxiolytic

pregabalin?

Should it be included here? It is approved for use in GAD in the European Union PablitoRun (talk) 21:11, 25 May 2010 (UTC)

Yes it should be, I have added it here. Thanks for pointing this out. I would encourage you to WP:BEBOLD and just add content to articles as long as it is sourced to a reliable source. :) Also you should add new comment sections to the bottom of talk pages, but not to worry, I spotted it this time. :)--Literaturegeek | T@1k? 22:05, 25 May 2010 (UTC)

SSRIs?

SSRIs are commonly prescribed for anxiety. Are they considered anxiolytics? Other than St John's Wort they aren't really mentioned in the article. --Galaxiaad 21:22, 30 July 2005 (UTC)

SSRIs are not anxiolytic, and St John's Wort is a multiple-reuptake inhibitor, amongst other things. To be considered anxiolytic, immediate relief of symptoms is required, and SSRIs take weeks to provide symptom relief, when at all effective. Studies have shown remarkably low long-term efficiacy of SSRIs in managing anxiety, although intermediate-term efficiacy is usually considered acceptable at sufficiently high doses once the "right one" has been found. Nardil (an MAOI) is generally the best long-term treatment for anxiety, if the patient is capable of following the dietary restrictions. Benzodiazepines, barbituates and carisoprodol are examples of short-term treatments for anxiety -Unregistered

Don't forget clonazepam. --Jeffreykopp 10/18/2005

Sure, there are like a million different drugs out there acting on the GABAergic system, and clonazepam is considered a highly potent benzodiazepine, which was covered by the GP.

More relevantly, do not forget opiates. The anxiolytic effects of opiates have been known for some time. My SO was fortunate enough to find a doctor willing to prescribe buprenorphine 0.2mg sublingual tablets for as-needed use; it takes about 15 minutes for a fullblown panic attack to fully subside, with no cognitive impairment, and the effect lasts for about 8-12 hours (some patients could theoretically have effect for 48 hours, based on the halflife). At the frequency she was getting the attacks at the time, there was no tolerance buildup at all; rebound effects appear to be nonexistent. Concurrent kappa-antagonism reduces the likelyhood of dependance in case of excessive use, and there will typically also be a significant antidepressant effect (attributable to both µ-agonism and K-antagonism).

Apart from benzos, barbs, soma, THC and opiates, there are (to my knowledge) no drugs that exhibit what I would call viable intrinsic anxiolytic activity. Sure, some neuroleptics will make you not give a damn about whether you even live or die, but most people I know who have taken them say they'd rather have the attacks; I can relate.

What these drugs have in common, is that they affect systems that are GABAergic or have efferent connections to GABAergic systems. Drugs lacking this property can safely be assumed to not have any significant short-term anxiolytic potential (exceptional claims and all that), though they may well exhibit long-term anxiolytic effects.

For management of continous, near-continous or high-frequency anxiety, the gold standard remains Nardil, even in the new formula (which appears to have reduced bioavailability for some patients; the cause has not been investigated, and it would presumably not be economically viable to do so). The reason is simple: it is a GABA-transaminase inhibitor whose primary metabolite is a potent (1mg/kg/dy will do) unselective and irreversible inhibitor of MAO, so it will give both tonic and phasic elevation of GABA, 5HT and DA, the three neurotransmitters that appear to be of primary relevance to the biological basis for anxiety.

Zuiram 03:43, 3 January 2007 (UTC)

Antidepressants such as SSRIs and tricyclic antidepressants are anxiolytic. Without being rude does anyone here actually know what the word anxiolytic means? Anxiolytic is a drug which relieves anxiety. It does not matter whether it takes a week for an SSRI to become effective, it is still an anxiolytic. The effectiveness of SSRIs is controversial in some circles but it is still classed as an anxiolytic because,,,, it is classed as having anxiolytic properties.--Literaturegeek | T@1k? 18:24, 18 December 2008 (UTC)

Agree that SSRIs should be mentioned. Would like to avoid a discussion about the definition of the term 'anxiolytic', but I will add a section mentioning the anxiolytic properties of SSRIs. I hope this is an acceptable solution. O.mangold (talk) 14:37, 3 August 2010 (UTC)

Beta blockers

I would not consider beta blockers 'anxiolytic' by definition as they work solely on somatic symptoms. Have amended article but could poss. take out.

Beta blockers are not anxiolytic per se. However, they can have an anxiolytic effect for some people. The reason for this is that the somatic symptoms frequently end up aggravating the anxiety, which becomes a kind of feedback loop. When the somatic symptoms are alleviated, the anxiety will lessen somewhat for these patients, at least breaking the loop, and occasionally helping the patient to recover from an attack as the relief can aid in restoring mental calm.

Removing them from the page makes little sense, but one could make a note that they do not have any intrinsic anxiolytic properties, rather having an indirect effect that is useful for some patients. That is to say, they will not calm down a person inhaling a high concentration of carbon dioxide, which the other anxiolytics will do; this is a classic test of efficacy. Note that buspirone has a very limited efficacy, and most people who have tried other anxiolytics report no effect whatsoever if switched over to buspirone.

Zuiram 03:26, 3 January 2007 (UTC)

Copyvio?

Some of the information on this page appears to be copied from http://www.absoluteastronomy.com/ref/anxiolytic and has been removed by me. This leaves some 'gaps' in the article, there are several other sentences that have been modified by other posters I've kept in. To be honest, I think this needs a complete rewrite - the structure was based on the material taken from the webpage and it's not now in any real order. That's why I added the cleanup tag.Berry 18:57, 25 April 2006

absoluteastronomy is a Wikipedia mirror. This is not a copyright issue. The text could be restored. Colin°^Talk 09:41, 27 April 2006 (UTC)

Rewrite

I have spent some time rewriting this page. Some things to remember for future editors: anxiolytics are agents used to treat the symptoms of anxiety - not an underlying anxiety pathology such as Generalized Anxiety Disorder. A lot of medications seem to have crept into this article that are not anxiolytics (such as neuroleptics). I've weeded them out. Ifnord 20:44, 24 July 2006 (UTC)

Thank you! The link dependence goes to a disambiguation page. I was going to change it to physical dependence but I wanted to make sure that was what was intended. I thought "dependence" was used for the physical aspect, and "addiction" for the psychological aspect, but it seems they aren't that well-defined and that it's basically a mess (in usage and on Wikipedia). Anyway, just wanted to check that it does indeed mean physical dependence here. --Galaxiaad 21:32, 24 July 2006 (UTC)

Indeed it's supposed to be physical dependence. I'll correct it. Ifnord 20:10, 25 July 2006 (UTC)

Etifoxine and Stresam

Could someone please add some information about the non-benzodiazepine anxiolytic etifoxine. It seems Stresam, a popular drug particularly in France for treating anxiety, makes use of this. Someone I know was on it, so I'm eager to find out more, but there doesn't seem to be info on Wikipedia yet. —The preceding unsigned comment was added by Steve Kroon (talk • contribs) 06:54, 26 March 2007 (UTC).

Other related medications where anxiety is not indicated

Opiates were mentioned which while definitely having an instant effect on anxiety are also a drug class all to themselves. (( Perhaps a warning about the extreme addictiveness of opiate drugs (from the relatively safe synthetic codine to definitely not safe 'recreational' class A drugs) would be insulting everyone's intelligence. ))

Etifoxine appears to have effects very similar to benzodiazapines, including having a molecular structure that includes a benzoxazine group - I can't determine if it is significantly different - it appears to be a GABA enhancer which is what benzos are.

There are many substances that have secondary anxiolytic effects and are used to treat GAD and panic symptoms. Several tricyclic antidepressants (eg doxepin) and the non-tricyclic (and extremely unusual) mirtazapine (all by virtue of having antihistamine effects) and most antipsychotic medications have major sedative side effects and they are often prescribed as if they were anxiolyics, usually given in smaller doses than is recommended for their primary use. Both of these classes of drug tend to loose their beneficial side effects after long term use.

There are several other drugs which have sedative and anxiolytic properties as side effects (one should not confuse sedation with anxiolytic properties as a patient may be quite physically sedated but still experience mental panic or stress - a problem with using antipsychotics for their sedative properties). (( a drug for treating some kinds of parethesia is indicated for panic attacks but I can't remember what it is called )) Even if they belong to another official class of drug, they may be worth a mention as drugs sometimes used in conjunction with more traditional anxiolytic medications, ie the anticonvulsant carbamazepine. Carbamazepine has some popularity as an assistant to antidepressants and anxiolytics.

I don't know what the official status of alcohol is (apart from being a general menace to the community) but, as a drug (ethyl as opposed to cleaning fluid), it is very non specific and prone to paradoxical effects vs being a strong CNS depressant - it can cause rage and mania as well as worsening depression. Also it is rather addictive in some individuals, to state the obvious. But, non-the-less, it acts instantly and often has strong anti-anxiety effects. It's ability to consistently reduce social phobia is well known by any 'social drinker'.

Marijuana also suffers from paradoxical effects vs being a CNS depressant, including causing panic attacks and paranoia. Rage, mood swings and violent behaviour are not known effects, though intoxication and, rarely, psychotic episodes are a problem. I suggest the reference to Marijuana remain as it is for now, though, as always, some citations would be useful (hint hint).

I'll leave it to someone with actual medical training (hehe) to decide for or against additions to this article re medications that touch anxiolytics while not strictly being a part of the classification. —Preceding unsigned comment added by Jp adelaide (talk • contribs) 15:02, 31 October 2007 (UTC)

Marijuana is in no way an anxiolytic. It actually increases anxiety in a huge number of people who use it. —Preceding unsigned comment added by 76.109.190.197 (talk) 01:09, 21 February 2008 (UTC)

I think that the section on marijuana should be edited. Marijuana does not have antipsychotic or anxiolytic effects, one of the chemicals contained in it has that effect. The reference is for CBD not marijuana, and the opening line of that reference states "A high dose of ∆9-tetrahydrocannabinol, the main Cannabis sativa (cannabis) component, induces anxiety and psychotic-like symptoms in healthy volunteers." So it would be good to clarify that.Essent (talk) 18:51, 28 February 2008 (UTC)

This article is not meant to be a guide on taking cannabis. There is noting really wrong in simply stating that cannabidiol is found in cannabis and is an anxiolytic drug. Even though I understand your reasoning I don't think we should talk about drugs that are not anxiolytic (like THC) in an article about anxiolytics. Also although I respect your opinion I don't think it's right to state that cannabis cannot be used as an anti-psychotic if that's what you were implying. There are about 1400 different varieties of cannabis, some have low THC values and although THC can induce those symptoms in healthy volunteers, when at such low doses in some varieites of cannabis, and with such high levels of CBD someone could use cannabis as a treatment for schizophrenia because THC does have theareputic effects. Cannabis has been used to treat anxiety disorders in the past, it's used to treat social anxiety disorders at least that I know. Also, there are what about 400 different chemicals in cannabis? I'm sure some others have anxiolytic type effects, but the main thing to point out is cannabdiol is only second to THC in quantity and as I've pointed out, in some varieties there is more CBD than THC, thus any negative effect of THC is cancelled out, and that's not original research the article itself aludes to this. Supposed (talk) 04:10, 19 May 2008 (UTC)

use of marijuana

marijuana can cause anxiety as well, this should definitely mentioned. —Preceding unsigned comment added by 86.154.155.214 (talk) 17:26, 26 March 2008 (UTC)

Cannabidiol does not induce anxiety, it's an anxiolytic drug! Stop referring to it as "marijuana".Supposed (talk) 16:29, 17 May 2008 (UTC)

Actually the first poster was probably right. There has been an association seen between cannabis use and anxiety. A very brief search finds this in a 2002 BMJ abstract:

• Conclusions: Frequent cannabis use in teenage girls predicts later depression and anxiety, with daily users carrying the highest risk. (http://www.bmj.com/cgi/content/full/325/7374/1195?eaf)

Whether or not this means it warrants a mention specifically on this page is another matter though.McPat (talk) 17:45, 18 November 2008 (UTC)

Nope it warrants no mention in the article because that is in reference to THC which is not an anxiolytic. The article is describing the effects of Cannabidiol. Supposed (talk) 12:30, 20 November 2008 (UTC)

That may be so, but the first poster was talking about 'marijuana' not CannabidiolMcPat (talk) 03:03, 23 November 2008 (UTC)

I just edited that section to change the word "marijuana" to "cannabis," because CBD and THC tend to be found in inverse proportions in various members of the cannabis family; industrial hemp typically contains about 4% CBD and less than 0.3% THC, whereas nearly all samples of marijuana (in California, where it's tested for medical purposes) have less than 1% CBD, and usually less than 0.1%, but contain over 3% THC. Since the recommended dose of CBD is in the 300-1300 mg/day range, that would mean that one would need to extract and consume the CBD from at least an ounce of marijuana a day to get the minimum dose, and more typically around 2 pounds a day. Or get the same dose from a few cents worth of non-intoxicating, industrial hemp flowers. So, while it's true that CBD is found in c, it is absolutely not useful as a source of medical CBD. I changed the wording to "cannabis" to be both more accurate and more neutral. 209.213.197.135 (talk) 03:27, 11 September 2009 (UTC)

I don't know where you're getting your figures from on CBD. If you look at any seedbank you will find that most cannabis strains contain lots of CBD, some even more than the amount of THC they contain! even going above 10% in some cases. It's well known that indica strains tend to be higher in CBD than sativa, and there are plenty of indica dominant marijuana strains out there. To suggest all marijuana strains contain 0.1% CBD is really misleading about the medicinal value of marijuana to act as an anxiolytic. Supposed (talk) 04:14, 13 September 2009 (UTC)

Hydroxyzine?

Why is this drug not mentioned? TimL (talk) 13:36, 17 May 2008 (UTC)

Good point, it should be listed. I just added it to the article with a citation.--Literaturegeek | T@1k? 14:19, 17 May 2008 (UTC)

Herbal treatments

http://en.wiki.x.io/wiki/Coriander links to this page but is not listed under the Herbal section, if someone could edit that in properly. I don't know how. 64.105.35.105 (talk) 09:39, 22 May 2008 (UTC) (Just wandering through)ki Likewise, the Chamomile page links to this, but is not included in the list of herbs. Can anyone support and write on Chamomile as an anxiolytic? The claim on the Chamomile page is it has this effect on rodents. IT looks like only 2-3 herbs currently listed are supported by adequate research. Does anyone know a source for the efficacy of Chamomile as an anxiolytic?

Benzodiazepines

"Benzodiazepines are prescribed for short-term relief of severe and disabling anxiety"

This seems a bit of asweeping statement - benzos arnt always prescribed for short term use only, and they are sometimes used for moderate as opposed to severe, disabeling anxiety

121.209.52.159 (talk) 01:55, 30 March 2010 (UTC) Jonathan

If you have a reference you can cite what you are saying in the article.--Literaturegeek | T@1k? 00:07, 31 March 2010 (UTC)

As of 2006, only Kava and Brahmi have shown anxiolytic effects in randomized clinical trials, and only Kava's effect has been independently replicated

Really? This article http://www.ncbi.nlm.nih.gov/pubmed/12652886 on lateriflora says valerian, kava-kava, St. John's Wort, passion flower, and hops have all been shown effective in double blind controlled studies. — Preceding unsigned comment added by 96.224.73.39 (talk) 19:27, 17 July 2011 (UTC)

a2 agonists

alpha-2 adrenoreceptor agonists such as clonidine and detomidine are indicated as sedatives and can produce a significant anxiolytic effect by preventing the release of adrenaline in both the CNS and PNS, reliving both the psychological and physiological symptoms of anxiety, they are sometimes used clinically for treating anxiety disorders with positive evidence from RCT's also. Would be nice if someone could add this class of drugs to the list sometime. 151.225.64.244 (talk) 23:02, 30 September 2014 (UTC)

Opiates / Opioids

Though no doctor would prescribe them for anxiety they certainly have anxiolytic properties.

http://www.ncbi.nlm.nih.gov/pubmed/25544740 — Preceding unsigned comment added by 78.146.5.156 (talk) 08:03, 17 March 2015 (UTC)

Why does discussion about anti-epileptics keep getting deleted

Anti epileptic medications (lamictal, Tegretol, topamax, pregabalin, etc) have been used for anxiety in doses lower than the anti-convulsant doses. When I've tried creating a category for them it got deleted.

I don't want to go through the trouble of creating the category again if it is just going to be deleted, so why is it deleted? If anything, anti-convulsants are a more mainstream therapy for anxiety than opioids, and opioids have their own category.

This article is a mess. In fact, at first reading I was surprised that anything else than benzos and barbs are treated in detail. Much more limited definitions on what anxiolytics are, exist: [1]. Opioids definitely shouldn't be included.Miacek (talk) 16:16, 10 May 2018 (UTC)

I agree that opioids should not be included. 2600:6C5E:107F:701:D8B8:B863:6089:AA05 (talk) 12:00, 19 September 2022 (UTC)

Other substances

Hello,

You should look into Etifoxine (Stresam), it already prescribed in France, Russia and other countries.

You could also talk about cannabinoids, especially CBD which is well known (CB1 modulator and 5HT1a agonist ...). Also CB receptors modulators like Kava.

You could also talk about potent plant extracts like Ashwagandha (reduces cortisol, works on 5HT2a...), Lemon balm (GABA transaminase inhibitor...), valerian root, lavender, ... Showing all different mechanisms.

You could also talk about amino acids like L-theanine (glutamic acid blocker, AMPA antagonist, NMDA agonist...), N-acetyl Cysteine, glycine, taurine, ... Also the mineral magnesium and especially magnesium glycinate.

You did not mention picamilon, which is simply GABA + Niacin ir order to make it able to pass through the blood brain barrier.

Thanks !

Whatever happened to the little audio button that helped in the pronunciation of so many words?

Its placement and availability had seemed to be on the rise, but now, rather suddenly it seems, it has just as simply and swiftly 'disappeared'...?

173.72.129.248 (talk) 04:40, 26 May 2022 (UTC)

Merger proposal

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.

Consensus to merge anti-anxiety medication into anxiolytic. Since I do not usually edit in medical topics with their specific sourcing requirements etc. I do not feel comfortable implementing the merger myself. Therefore requesting assistance from the participants, Crunchydillpickle, Doctormatt, Bibeyjj and Mjǫðr Felix QW (talk) 21:58, 16 September 2022 (UTC)

---

I propose merging anti-anxiety medication into anxiolytic. I think the content in anti-anxiety medication, which includes more history and context, can be easily added to anxiolytic, which currently is more focused on discussing specific medications. I don't anticipate article size or weighting problems. I'm rather new around here, and I'm not an expert on anxiety meds, so please let me know if I'm totally off base. Thanks! Crunchydillpickle (talk) 15:13, 2 June 2022 (UTC)

This seems like a good idea to me. The articles seem to be covering the same topic. I'm not an expert on anxiety meds, and I've never merged articles, but this seems to make sense here. Cheers! Doctormatt (talk) 17:59, 2 June 2022 (UTC)

Support. These articles cover the same topic. It's quite a big job to merge them both, though! I think that "anti-anxiety medication" should be merged into "anxiolytic", mostly preserving the drug descriptions from "anxiolytic" but adding the "Nature", "Aetiology", and "Clinical Use" sections from "anti-anxiety medication. Bibeyjj (talk) 16:16, 9 June 2022 (UTC)

Support appear to cover the same subject matter. Graeme Bartlett (talk) 09:50, 8 July 2022 (UTC)

Anxiolytic and anti-anxiety are synonymous, so I agree the two pages should be merged. Mjǫðr (talk) 22:07, 30 July 2022 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Merging from Anti-anxiety medication

Okay, I merged Anti-anxiety medication into Anxiolytic. There is a lot of redundancy, or at least each drug gets talked about in multiple sections. I am wondering about the structure. Would it make sense to simply have a section for each medication (or type?), with all information about that medication in that section? As it is, things are a bit of a mess. Thoughts? Doctormatt (talk) 23:22, 16 September 2022 (UTC)

You absolutely butchered what was a perfectly fine page for seemingly no reason. You, you singular nobody doosh, undid several years of work from countless contributors in very short order. You had no permission to do this and worst of all, your ridiculous clutter has made what was a very helpful and informative page about a serious and important topic moot. It was structured succinctly until you came along. It was well sourced, well written, accessible, and of high quality...until you came along. How very unbecoming. 2600:6C5E:107F:701:D8B8:B863:6089:AA05 (talk) 11:56, 19 September 2022 (UTC)

Please see the merge proposal above: The changes to the page are a result of the merger. The Anti-anxiety medication article had a bunch of information that was not contained in Anxiolytic, and now that all the information is in one article it needs to be cleaned up and have its structure improved, etc. I am trying to help, and did the best I could. I agree that the page needs works after this merger, and I would be happy to have your help in doing this work. Cheers! Doctormatt (talk) 18:09, 19 September 2022 (UTC)

Dear IP,

I am sorry you are unhappy with the current state of the page. However, Doctormatt has merely been helpful by implementing the merge decision that was reached above by consensus of all the five editors who made their opinions known. Please assume good faith and refrain from making personal attacks against other editors.

Should you have any constructive suggestions as how better to integrate the newly merged content, or on certain parts of it that you would prefer to be left out, then please contribute by editing the article yourself and/or by making concrete and constructive suggestions on this talk page. Felix QW (talk) 20:44, 19 September 2022 (UTC)

I am going to ignore your hyper-sensitivity, Felix. I did not make a personal attack against Matt. Any critique of an individual's behavior does not automatically equate to a "personal attack". In response to Matt (I'm not going to call you doctor unless I see credentials): I already helped. I contributed heavily around a year ago to this page which was an absolute mess before I gave it structure, made it clear and accessible, and added much needed sourcing. You muddied the waters for seemingly no good reason. I don't care that 5 people agreed with your merger. No one was clamoring for a merger. This page was well sourced, well written, and easily digestible before you did a hackjob on it. Now it is unbelievably messy. The ordering is chaotic, the page is jumbled, confusing, and simply odd. What is this new page? This is a weird mashing of several concepts with repetitious sentencing. People want a wikipedia page that simply states what the word 'anxiolytic' means and then a list of anxiolytics... which is what the page was... before you butchered it. Felix, go ahead and cry some more about how I'm being such a bad boy by simply fairly critiquing someone's unhelpful contributions. Emotional manipulation tactics don't work on me but they may sway someone else who stumbles upon this. 2600:6C5E:107F:701:3531:2D:1462:D0A1 (talk) 10:34, 21 September 2022 (UTC)

To reply to Doctormatt's earlier comment about how to structure it, I am not completely sure. WP:MEDORDER for "drugs" doesn't really have a defined solution for classes of drugs. I think that the "History" section could be moved to the end of the article. The "Classification" section is probably the most in need of clean-up, and perhaps we could keep the "Clinical use" section and move content from "Classification" to there. Then, the theory of different drug actions is explained before the drugs are mentioned in more detail, and each drug can have its contraindications and adverse effects listed with it. What do you think? Bibeyjj (talk) 09:14, 29 September 2022 (UTC)

Thanks, @Bibeyjj. This sounds good. I'm not sure we need contraindications or adverse effects at all, since those are available at the full article for each drug. I think if we rely heavily on "Main article" links (as is done at hypnotic), we can simplify the page a great deal and get it into much better shape. Cheers! DoctorMatt (talk) 05:00, 30 September 2022 (UTC)

coming back after a few months, still can't believe how badly you butchered what was a great page. Before you came around the page simply stated the definition of the word 'anxiolytic' then listed groupings/examples of medications that fit the definition. It was very well sourced. I personally spent I'd estimate around 20 hours in total here and there over several weeks back in 2021 bettering the page. This is a topic I am quite passionate about. Man, this still hurts several months later. Completely needless, uncalled for action by one individual. Now people will have a mucher harder time deciphering which medication may or may not be right for them. 2600:6C5E:107F:701:74BF:17BD:3070:7745 (talk) 11:54, 19 November 2022 (UTC)

'List of anxiolytics'

Please note that an article was created attempting but failing to duplicate content from this article. I have since redirected it here. TheTechnician27 (Talk page) 23:59, 11 August 2023 (UTC)