Editing Anxiolytic (section)

== Classifications ==
There are six groups of anti-anxiety medications available that have been proven to be clinically significant in treatment of anxiety disorders.<ref name="Rang Dale 2012">{{Citation |title=Rang and Dale's Pharmacology 7th Edition Preface |date=2012 |url=http://dx.doi.org/10.1016/b978-0-7020-3471-8.00064-0 |work=Rang &amp Dale's Pharmacology |pages=xv |publisher=Elsevier |doi=10.1016/b978-0-7020-3471-8.00064-0 |isbn=9780702034718 |access-date=2022-03-16|url-access=subscription }}</ref>  The groups of medications are as follows.
{| class="wikitable"
!Drug Class
!Examples
|-
|[[Antidepressant]]s (e.g., SSRIs, SNRIs)
|SSRIs e.g., fluoxetine, sertraline; SNRIs e.g., venlafaxine; MAOIs; TCAs
|-
|[[Benzodiazepine]]s
|Lorazepam, diazepam, alprazolam
|-
|[[Azapirone]]s
|Buspirone, gepirone, tandospirone
|-
|[[Anticonvulsant|Antiepileptics]]
|Gabapentin, pregabalin, tiagabine and valproate
|-
|[[Antipsychotic]]s
|Olanzapine, risperidone
|-
|[[Beta blocker|Beta-adrenoceptor antagonists]]
|Propranolol, atenolol
|}

=== Antidepressants ===
Medications that are indicated for both anxiety disorders and depression. [[Selective serotonin reuptake inhibitor]]s (SSRIs) and [[serotonin–norepinephrine reuptake inhibitor]]s (SNRIs) are new generations of antidepressants. They have a much lower adverse effect profile than older antidepressants like monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs). Therefore, SSRIs and SNRIs are now the first-line agent in treating long term anxiety disorders, given their applications and significance in all six types of disorders.<ref name="Rang Dale 2012" />

=== Benzodiazepines ===
[[Benzodiazepine]]s are used for acute anxiety and could be added along with current use of SSRIs to stabilize a treatment. Long-term use in treatment plans is not recommended. Different kinds of benzodiazepine will vary in its pharmacological profile, including its strength of effect and time taken for metabolism. The choice of the benzodiazepine will depend on the corresponding profiles.<ref name="Rang Dale 2012" />

Benzodiazepines are used for emergent or short-term management. They are not recommended as the first-line anti-anxiety drugs, but they can be used in combination with SSRIs/SNRIs during the initial treatment stage.<ref name="CAMH" /> Indications include panic disorder, sleep disorders, seizures, acute behavioral disturbance, muscle spasm and premedication and sedation for procedures.<ref>{{Cite web |title=Benzodiazepines: What They Are, Uses, Side Effects & Risks |url=https://my.clevelandclinic.org/health/treatments/24570-benzodiazepines-benzos |access-date=2024-01-15 |website=Cleveland Clinic |language=en}}</ref>

=== Azapirones ===
Buspirone can be useful in GAD but not particularly effective in treating phobias, panic disorder or social anxiety disorders.<ref name="Elsevier 2018" /> It is a safer option for long-term use as it does not cause dependence like benzodiazepines.<ref>{{Cite web |date=2022-11-23 |title=BuSpar For Anxiety: Is It Right For Me? {{!}} Klarity |url=https://www.klarityadhd.com/post/buspar-for-anxiety-is-it-right-for-me/ |access-date=2023-10-19 |website=www.klarityadhd.com |language=en-US}}</ref>

=== Antiepileptics ===
Antiepileptics are rarely prescribed as an off-label treatment for anxiety disorders and post-traumatic stress disorders.<ref>{{Cite web |date=2014-10-28 |title=What is the Best Anticonvulsant for Anxiety? |url=https://psychcentral.com/anxiety/antipsychotics-anticonvulsants-for-anxiety-disorders |access-date=2023-10-19 |website=Psych Central |language=en}}</ref> There have been some suggestions that they may help with anxiety symptoms but there is generally a lack of research on its use.<ref name="Garakani 2020">{{Cite journal |last1=Garakani |first1=Amir |last2=Murrough |first2=James W. |last3=Freire |first3=Rafael C. |last4=Thom |first4=Robyn P. |last5=Larkin |first5=Kaitlyn |last6=Buono |first6=Frank D. |last7=Iosifescu |first7=Dan V. |date=2020 |title=Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options |journal=Frontiers in Psychiatry |volume=11 |doi= 10.3389/fpsyt.2020.595584|doi-access=free |pmid=33424664 |pmc=7786299 |issn=1664-0640}}</ref>

One antiepileptic, [[pregabalin]], has been found to be better at treating GAD than a placebo, and comparable effects to benzodiazepines. It has also been shown be potentially efficient in treating social anxiety disorder. [[Gabapentin]] has been prescribed off-label for anxiety despite a lack of research evidence supporting such use, although some studies have indicated that it may relieve anxiety symptoms. The potential anxiolytic effect of [[tiagabine]] has been observed in some pre-clinical trials, but its effectiveness has not yet been proved. Similarly, there is a lack of research on [[valproate]] for the treatment of anxiety disorders.<ref name="Garakani 2020" />

=== Antipsychotics ===
[[Olanzapine]] and [[risperidone]] are atypical antipsychotics which are also effective in GAD and PTSD treatment. However, there is a higher chance of experiencing adverse effects than the other anti-anxiety medications.<ref name="Rang Dale 2012" />

=== Beta-adrenoceptor antagonists ===
[[Propranolol]] is originally used for high blood pressure and heart diseases. It can also be used to treat anxiety with symptoms like tremor or increased heart rate. They work on the nervous system and alleviate the symptoms as a relief.<ref name="Rang Dale 2012" /> Propranolol is also commonly used for public speaking when one is nervous.<ref name="Garakani 2020" />