Anxiety can be a part of some bigger syndrome, a symptom of some condition or be a Generalized Anxiety Disorder – an anxiety that is ongoing for more than six month and can be the result of heredity or a history of substance abuse.
For generalized anxiety disorder the reason for anxiety is not important – human psychic is arranged in a way that if there is a feeling – the mind will often find the reason for that feeling or make it up and believe in it. That way the feeling is built into the system of the world, it is not random, it can be logically explained.
The big group of anti-anxiety medication is called anxiolytics. They include medication from other groups that have a quality of decreasing anxiety and calming the patients down.
Barbiturates are an old group that was used to treat insomnia, but although it gives a great deep sleep – the patients wake up heavy-headed and not as well rested as after modern sleeping pills. They are still widely used though, also because of their quality to block seizures. Not good with alcohol – they potentiate each other and the effect can be called recreational and dangerous.
Benzodiazepines are a more modern group – they include such legendary names as Xanax, Klonopin and Valium. Similar effect with Barbiturates only the phases of sleep are preserved so a patient would wake up fresh and well rested. Also are used as anti-seizure medication. At smaller dosages they are used against anxiety, a great tool, especially taking into consideration that dependency risk is much smaller compared to barbiturates.
Carbamates is an old group and it is not widely used anymore. Modern muscle relaxant Soma after it gets into bloodstream is metabolized to meprobamate, which is a carbamate. Tha explains why Soma has certain anxiolytic activity as well. This is called “prodrug” in pharmacology – a drug that would not act unless metabolized into active components into the bloodstream.
Antihistamines have mild anxiolytic activity but they are not used in practice to treat anxiety. It is just good to know that some of them can also take away the anxiety after a spider byte or a bee sting.
Opioids – besides a great painkilling effect they also have an anxiolytic effect, which probably adds to their addictiveness. Fentanil, morphine, heroin are the common representatives. The weakest and the most innocent of them is Tramadol, which is probably why it is used so widely. Morphine is the oldest representative and has a great painkilling effect, but it should only be taken via injections which is very inconvenient. Acid environment of the stomach combined with enzymes deactivates morphine, this fact saved several lives of those who wanted to commit suicide by drinking themselves into morphine overdose from the ampules.
Tramadol is several times weaker than morphine (since morphine is the oldest representative – every next opioid that appears is measured on a scale against morphine), but it is still a pretty good analgesia, so patients with traumas and chronic pains often use it.
Antidepressants have a great anxiolytic activity, their only drawback may be that they take several weeks to start working. We have described antidepressants in separate section.