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Calming pills for anxiety, stress and and restlessness

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Last reviewed: 07.06.2024
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Anxiety medications, also called anxiolytics, are commonly used to reduce symptoms of anxiety and tension. Below is an overview of some of them. However, a physician or psychiatrist should be consulted for accurate recommendations and prescriptions, as well as for individual patient considerations.

List of pills for anxiety, stress and worry

Anxiolytics can be divided into several groups depending on their chemical structure and mechanism of action. Some of the best known groups of anxiolytics include:

  1. Benzodiazepines: Examples include alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium), clonazepam (Klonopin), and others. Benzodiazepines can be effective but can be addictive, so they should be used with caution and under a doctor's supervision. Benzodiazepines act as GABA (gamma-aminobutyric acid) inhibitor enhancers, resulting in decreased nervous system activity and reduced anxiety.
  2. Antidepressants, selective serotonin reuptake inhibitors (SSRIs): Examples include sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac), and others. These antidepressants may also help with anxiety disorders.
  3. Selective serotonin and norepinephrine reuptake inhibitors (SSRIs): Examples include venlafaxine (Effexor) and duloxetine (Cymbalta). They can also be used to treat anxiety.
  4. Barbiturates: Barbiturates such as phenobarbital were previously used as anxiolytics, but they are now rarely used because of the potential for addiction and overuse.
  5. Azapyridines: Examples in this group include buspirone (Buspar), which is a non-primary anxiolytic and is not a benzodiazepine.
  6. Antipsychotics: Some antipsychotics can be used to treat anxiety disorders, such as quetiapine (Seroquel) and aripiprazole (Abilify).
  7. Pregabalin (Lyrica) and gabapentin (Neurontin): These drugs, originally developed to treat epilepsy, can also be used to treat anxiety disorders.
  8. Tricyclic antidepressants (TCAs): Some TCAs, such as amitriptyline (Elavil), can be effective in treating anxiety, but they are usually used when other medications have failed.

It is important to emphasize that the use of anxiolytics should be supervised by a physician and the dosage should be individualized. Uncontrolled use of anxiolytics can lead to dependence and other undesirable effects. The physician will evaluate and select the most appropriate drug and treatment method depending on the specific clinical case and the needs of the patient.

Indications Anxiolytics

Anxiolytics, or anxiety medications, may be prescribed by a doctor in the following cases and signs:

  1. Anxiolytics are often used to treat generalized anxietydisorder (GAD), social anxiety disorder, and other forms of anxiety disorders. Patients with GAD experience increased anxiety tension and worry for no apparent reason.
  2. Panic attacks: Anxiolytics can help treat panic attacks and panic disorder. Patients with panic disorder often experience sudden and intense anxiety attacks.
  3. States of stress: Anxiolytics may be temporarily prescribed to alleviate anxiety symptoms associated with short-term stressful situations such as family crises, loss of a loved one, psychological trauma, and other events.
  4. Somatic symptoms of anxiety: Some patients with anxiety disorders may have somatic symptoms such as muscle tension, abdominal pain, headaches, and other physical manifestations. Anxiolytics can help reduce these symptoms.
  5. Insomnia: In cases where anxiety is the underlying cause of insomnia, anxiolytics may help improve sleep.
  6. Other conditions: In some cases, anxiolytics may be prescribed to treat other conditions such as anxiety associated with thyrotoxicosis (overactive thyroid gland), unconscious anxiety attacks, and others.

When prescribing anxiolytics, the doctor takes into account the individual characteristics of each patient and chooses the appropriate drug and dosage. It is important to use these medications under the supervision of a physician, as they can have side effects and the potential for addiction, especially with prolonged and inappropriate use. Anxiolytic therapy is often combined with psychotherapy to achieve the best results in the treatment of anxiety disorders.

Release form

Anxiolytics such as benzodiazepines, antidepressants, and other drugs are available in a variety of dosage forms to meet the needs of patients and provide the convenience of taking the medication. Here are some of the most common dosage forms of anxiolytics:

  1. Tablets and capsules: These are the most common form of release of anxiolytic medications. They are easily dosed and taken orally with water.
  2. Solutions: Some medicines may be available as liquid solutions that can be taken orally. These solutions may be convenient for children or patients who have difficulty swallowing solid tablets.
  3. Drops: Some anxiolytics, such as anxiolytic eye drops (e.g., alprazolam), may be used as drops for subcutaneous administration.
  4. Injections: Some anxiolytics can be administered to the patient using injections, which can be given intravenously (vein), intramuscularly, or subcutaneously.
  5. Patches: Some medications may be available as patches that attach to the skin and provide a gradual release of the active ingredient into the body.
  6. Syrups: Syrups may be available for children or patients who have difficulty swallowing solid forms of medication.
  7. Dissolvable tablets and swellable tablets: These tablets dissolve in the mouth or in water and provide convenience.
  8. Inhalation products: Some anxiolytics may be presented as inhaled products that are inhaled through the lungs.

The form of release depends on the specific drug and its characteristics, as well as the needs and capabilities of the patient. When prescribing anxiolytics, the physician considers many factors, including the type and degree of anxiety disorder, the patient's age and physical condition, to select the most appropriate dosage form and method of treatment.

Pharmacodynamics

The pharmacodynamics of anxiolytics relate to their effects on chemical systems in the brain that regulate anxiety levels.

Primarily, anxiolytics affect neurotransmitters such as gamma-aminobutyric acid (GABA) and serotonin, which play a key role in the regulation of mood and anxiety. Here are some of the mechanisms of action of anxiolytics:

  1. GABA potentiation: GABA is a neurotransmitter that inhibits neuronal activity and reduces nervous system excitability. Most anxiolytics enhance the action of GABA by increasing its concentration in synaptic clefts. This leads to a decrease in neuronal excitability and anxiety.
  2. Effects on serotonin: Some anxiolytics, such as drugs in the selective serotonin reuptake inhibitor (SSRI) group, affect the serotonin receptor system. Serotonin is a neurotransmitter associated with mood regulation, and its levels can affect anxiety. Anxiolytics of this group increase the availability of serotonin in synaptic clefts.
  3. Other mechanisms: Some anxiolytics may affect other neurotransmitters and systems such as norepinephrine and glutamate, although their exact mechanisms of action may differ.

The pharmacodynamics of anxiolytics can be complex, and the efficacy of specific medications may vary from patient to patient.

Main pharmacological effects of anxiolytics and their mechanism of action

  1. Reduction of anxiety: The main pharmacological effect of anxiolytics is the reduction of subjective anxiety and restlessness in the patient. This is manifested by an improvement in emotional state and a reduction in internal tension.
  2. Muscle relaxation: Anxiolytics can help relax skeletal muscles, which may be helpful for muscle tension associated with anxiety.
  3. Sedative effects: Many anxiolytics have sedative effects, which can lead to improved sleep and decreased arousal.
  4. Anticonvulsant action: Some anxiolytics also have anticonvulsant properties and can be used to treat seizure conditions.
  5. Mechanism of Action: Many anxiolytics enhance the action of the neurotransmitter gamma-aminobutyric acid (GABA) in the central nervous system. GABA is an inhibitory neurotransmitter that reduces neuronal excitability. Anxiolytics can either increase the release of GABA or enhance its action at receptors. This decreases neuronal excitability and reduces anxiety.
  6. Action on serotonin and other neurotransmitters: Some anxiolytics, such as selective serotonin reuptake inhibitors (SSRIs), can affect serotonin levels in the brain, which can also affect mood and anxiety.
  7. Effect on alpha-beta-adrenoreceptors: Some anxiolytics may have an effect on adrenoreceptors, which affects the levels of adrenaline and noradrenaline in the body.

It is important to note that the mechanisms of action of anxiolytics may differ depending on the specific drug, their classification and subtype. The choice of a particular anxiolytic and its mechanism of action depends on the diagnosis, severity of symptoms and individual patient characteristics.

Pharmacokinetics

The pharmacokinetics of anxiolytics, like any other drugs, describes how they are absorbed, distributed, metabolized, and excreted from the body. These parameters can vary depending on the particular anxiolytic. Here are the general aspects of pharmacokinetics:

  1. Absorption: Anxiolytics may be taken orally (oral) or as injections. Oral forms are usually absorbed in the gastrointestinal tract and may have varying rates and completeness of absorption depending on the drug.
  2. Distribution: Anxiolytics can be distributed to organs and tissues of the body. Some have the ability to accumulate in certain organs, which may affect their duration of action.
  3. Metabolism: Many anxiolytics are metabolized in the liver. The process of metabolism can alter the activity of the drug and its duration of action. The metabolic pathways and enzymes involved in metabolism may vary between anxiolytics.
  4. Excretion: Excretion of anxiolytics is via the kidneys and/or liver. This may occur as metabolites (metabolic products) or unchanged. The rate of excretion may vary depending on the drug and the functional status of the patient's kidneys and liver.
  5. Half-elimination (half-life): Half-elimination is the time in which the level of a drug in the blood is halved. The half-lives of anxiolytics vary and can range from a few hours to a few days, depending on the drug.
  6. Effect of food: Some anxiolytics may interact with food, which may affect the rate and extent of their absorption from the gastrointestinal tract.

It is important to note that pharmacokinetics can vary for different anxiolytics, so it is important to follow your doctor's instructions and the information in the official drug labeling when prescribing and taking anxiolytics.

Dosing and administration

The dosage and route of administration of anxiolytics can vary significantly depending on the specific drug and the individual needs of the patient. Here is some general information on the route of administration and dosages of several anxiolytics:

  1. Alprazolam (Xanax):

    • Dosage: Usually start with a low dose, such as 0.25 mg to 0.5 mg two or three times a day.
    • How to use: It is taken orally with water. Doses and frequency may be adjusted depending on the response to treatment.
  2. Lorazepam (Ativan):

    • Dosage: Usually start with a dose of 2 mg to 3 mg per day, divided into several doses.
    • Directions for use: It is taken orally.
  3. Diazepam (Valium):

    • Dosage: Usually start with a dose of 2 mg up to 10 mg two or three times a day.
    • Directions for use: It is taken orally.
  4. Buspirone (Buspar):

    • Dosage: Usually start with a dose of 5 mg up to 10 mg two or three times a day.
    • How to use: It is taken orally. Several weeks of treatment may be required to achieve maximum effect.
  5. Selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft ) or escitalopram (Lexapro):

    • Dosage: Usually start with a low dose and increase gradually over several weeks under a doctor's supervision.
    • Directions for use: It is taken orally.

It is important to realize that dosage and recommendations for use may vary widely depending on the specific diagnosis, clinical presentation and response to treatment. Patients should always follow their physician's instructions and should not change the dosage or regimen without their physician's consent.

Anxiolytics sleeping pills

Anxiolytics are generally not sleeping medications, but some may cause drowsiness in some patients. This is an individual reaction to the medication and may depend on the type of anxiolytic and its dosage.

The following anxiolytics may cause drowsiness in some people:

  1. Diazepam(Valium): Diazepam may cause drowsiness and depress nervous system activity.
  2. Alprazolam (Xanax): This drug may also cause drowsiness.
  3. Lorazepam (Ativan): Lorazepam may cause drowsiness in some patients.
  4. Clonazepam (Klonopin): This medication may cause drowsiness.

If you need to take anxiolytics and you notice drowsiness as a side effect, it is important to discuss this with your doctor. Your doctor may recommend lowering the dose, changing the timing of the medication, or considering other treatment options.

If you need medication to help with insomnia, your doctor may prescribe sleeping pills or another medication specifically designed to improve sleep. You should strictly follow your doctor's recommendations for the use of any medication and not increase the dose without his or her consent.

Daytime anxiolytics

These are anxiolytic medications that do not cause drowsiness and are designed to manage anxiety and anxiety symptoms throughout the day without significantly affecting wakefulness. These medications can be helpful for patients who need to stay active and alert during the day. Below are some anxiolytics that generally do not cause drowsiness and can be used throughout the day:

  1. Buspirone (Buspar): Buspirone is often used as a daytime anxiolytic. It does not usually cause drowsiness and is not physically addictive.
  2. Hydroxyzine (Vistaril): Hydroxyzine can be used to treat anxiety and allergic reactions. It has sedative effects, but is often used in daily dosages without significant drowsiness.
  3. Hydroxyzine (Atarax): This is an analog of hydroxyzine that can be used during the daytime without significant drowsiness.
  4. Valerian: This herbal remedy can be used to reduce anxiety. Valerian does not usually cause drowsiness, but individual reactions may vary.
  5. Treatment with psychotherapy: Some forms of psychotherapy, such as cognitive behavioral therapy (CBT), can also help manage anxiety without the use of medication.

It is important to note that the response to anxiolytics can vary from patient to patient, and some people may still experience drowsiness or other side effects when taking these medications.

Use Anxiolytics during pregnancy

The use of anxiolytics during pregnancy requires special caution and discussion with a physician, as many of them may affect fetal development. The decision to use anxiolytics should be based on the weight of the benefits to the mother and the risks to the development of the baby, and should be made in conjunction with a physician specializing in obstetrics and gynecology.

Some anxiolytics may be relatively safe for use during pregnancy, but even then their prescription and dosage should be strictly monitored by a medical professional. In addition, the choice of a particular drug may depend on the degree of anxiety and clinical parameters.

Benzodiazepines, for example, can be used when necessary but preferably in minimal doses and for short periods of time. However, some benzodiazepines may be associated with a risk of neonatal withdrawal if used during the third trimester of pregnancy.

Alternatives to anxiolytics include psychotherapeutic techniques such as cognitive behavioral therapy (CBT), relaxation, and other methods that can help pregnant women manage anxiety without medication.

If you are pregnant and experiencing anxiety symptoms, it is important to discuss your concerns and treatment options with your doctor. Together with your doctor, you can make informed decisions about how best to manage your anxiety during pregnancy. You should not take anxiolytics without consulting a medical professional to avoid possible risks to your and your baby's health.

Contraindications

Contraindications for the use of anxiolytics can vary from drug to drug, but there are general categories of patients and conditions in which the use of anxiolytics may be undesirable or even dangerous. Here are some common contraindications for anxiolytics:

  1. Individual intolerance: If the patient has a known allergic reaction or intolerance to any anxiolytic or its components, the use of this drug is contraindicated.
  2. Pregnancy and breastfeeding: Some anxiolytics may have adverse effects on fetal development or may pass into breast milk. Their use should be closely monitored by a physician, and the administration of anxiolytics may require adjustments in terms of dosage or choice of drug.
  3. Children: Many anxiolytics are not recommended for children and adolescents because their safety and efficacy in this age group may not be well understood.
  4. Respiratory disorders: The use of some anxiolytics may increase symptoms of respiratory disorders, especially in patients with bronchial asthma or chronic obstructive pulmonary disease (COPD).
  5. Alcohol and drugs: In combination with alcohol or drugs, anxiolytics may cause dangerous depression of the central nervous system and respiratory functions.
  6. Other medicines: Some anxiolytics may interact with other medicines, including antidepressants, antipsychotics, and opioids. Your doctor should consider all medications the patient is taking when prescribing anxiolytics.
  7. Glaucoma: Anxiolytics can increase intraocular pressure, which can be dangerous for patients with glaucoma.
  8. Mental Disorders: In some patients with mental disorders such as schizophrenia or bipolar disorder, anxiolytics may cause worsening of symptoms or may be incompatible with the medication used.

Side effects Anxiolytics

Side effects of anxiolytics can vary depending on the specific drug and individual patient characteristics. The following are common side effects that may occur when taking anxiolytics:

  1. Drowsiness: This is one of the most common side effects of anxiolytics. Many patients may feel increased drowsiness, especially at the beginning of treatment.
  2. Decreased coordination: Some anxiolytics may affect motor skills and coordination, which may increase the risk of accidents when driving or operating machinery.
  3. Dizziness: Many patients may experience dizziness while taking anxiolytics.
  4. Dreaming dreams: Some patients may experience dreaming dreams or nightmares.
  5. Insomnia: On the contrary, anxiolytics may cause insomnia or changes in sleep patterns in some patients.
  6. Abdominal pain: Some anxiolytics may cause abdominal discomfort, nausea, or vomiting.
  7. Dry mouth: This side effect may be caused by decreased salivary secretion activity.
  8. Changes in appetite: Anxiolytics may affect appetite and lead to an increase or decrease in body weight.
  9. Decreased libido: Some anxiolytics can affect sexual function and libido levels.
  10. Dry skin: Some patients may experience dry and irritated skin.
  11. Allergic reactions: Rarely, anxiolytics may cause allergic reactions such as skin rash, itching, or swelling.
  12. Dependence and withdrawal: Some anxiolytics can cause physical or psychological dependence, and when they are discontinued, withdrawal may develop, which may include anxiety, insomnia, and other symptoms.

It is important to remember that not all patients will experience these side effects, and the intensity of side effects may vary. Before starting treatment with anxiolytics, it is important to discuss all side effects and risks, as well as the benefits of treatment, with your doctor. You should also adhere to your doctor's recommendations and not change the dosage or discontinue the medication without your doctor's consent.

Overdose

An overdose of anxiolytics can be dangerous and requires immediate medical attention. Symptoms of overdose may vary depending on the specific drug, dose, and individual body characteristics, but may include the following:

  1. Drowsiness and dizziness.
  2. Slowing of breathing and pulse.
  3. Loss of consciousness or fainting.
  4. Weakness and ataxia (impaired coordination of movements).
  5. Blurred vision and eye irritation.
  6. Digestive disorders, including nausea and vomiting.
  7. Hypothermia (decreased body temperature).

If an anxiolytic overdose is suspected, call for emergency medical assistance immediately or go to the nearest emergency room. Doctors will be able to assess the patient's condition and take appropriate measures to treat the overdose. These measures may include:

  1. Individualized treatment of overdose symptoms, such as performing artificial ventilation or administering medications to stimulate breathing and cardiovascular activity.
  2. Use of anxiolytic antagonists such as flumazenil (Romazicon), which is an antagonist of benzodiazepines and can reverse their effects.
  3. Ensuring the stability of the patient's condition, including maintaining normal blood pressure and blood sugar levels.

It is important to remember that an overdose of anxiolytics can be dangerous and even fatal. Therefore, you should take all precautions when storing anxiolytics and follow your doctor's recommendations regarding dosage and administration of the medication.

Interactions with other drugs

Anxiolytics may interact with other drugs and this is an important consideration when prescribing them. Interactions can affect the effectiveness of the medication, cause side effects, or increase the risk of complications. Here are some of the possible interactions of anxiolytics with other drug groups:

  1. Alcohol: Alcohol in combination with anxiolytics may increase central nervous system depression and decrease the response to anxiolytics. This may lead to drowsiness, coordination disorders and other side effects.
  2. Antidepressants: Anxiolytics and antidepressants are often used together to treat various mental disorders. However, some combinations of anxiolytics and antidepressants can cause serotonin excess syndrome, which can be dangerous. Therefore, it is important to use caution and doctor's supervision when prescribing these medications at the same time.
  3. Antipsychotics: Combining anxiolytics with antipsychotics may increase the sedative effect and increase the risk of side effects such as somnolence and hypotension.
  4. Opioids: Anxiolytics may increase the depressant effect of opioids on the central nervous system, which may lead to decreased breathing and consciousness. This combination can be dangerous and requires careful monitoring.
  5. Antihistamines: The combined use of anxiolytics and antihistamines (allergy medicines) may increase sedation and drowsiness.
  6. Diuretics: Anxiolytics may affect the metabolism of water and electrolytes in the body. When they are combined with diuretics (drugs that increase fluid excretion), there may be an additional risk of electrolyte imbalance.
  7. Anticonvulsants: Combining anxiolytics with anticonvulsants may alter the effectiveness of both types of drugs.

This is not a complete list of interactions, and many factors, including the choice of specific anxiolytic and dosage, can affect the risk of interactions. It is always important to consult with your doctor and provide him or her with complete information about all medications you are taking, including prescription and over-the-counter medications.

Over-the-counter anxiolytics

Most anxiolytic drugs (anxiolytics) require a doctor's prescription to purchase and use. This is because anxiolytics can have side effects and are potentially addictive, and their use should be monitored by a doctor. In most countries, these drugs are prescription drugs and are available only when prescribed by a specialist.

However, there are some natural and over-the-counter remedies that can help manage anxiety and stress. For example:

  1. Valerian: This is an herbal remedy that can help reduce anxiety and help you relax. Valerian is available over-the-counter as tablets, capsules, tea, or drops.
  2. Geranium: This is another herbal remedy that can help relieve anxiety. It is also available over-the-counter in various forms.
  3. Lavender: Lavender essential oil can be used for aromatherapy and to help you relax. It is available without a prescription.
  4. Breathing exercises and relaxation: Simplebreathing techniques and relaxation methods can be effective in reducing anxiety and stress.
  5. Sports and physical activity: Regular exercise can help reduce anxiety and improve mood.

While these over-the-counter remedies are available, it is important to remember that they may have different effectiveness for different people.

Attention!

To simplify the perception of information, this instruction for use of the drug " Calming pills for anxiety, stress and and restlessness" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.

Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.

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