Anxiolysis

Fears are a natural part of human emotion. Everyone has them and everyone needs them in order to be able to react advantageously in dangerous situations. If they get out of hand, however, they are pathological forms of anxiety (anxiety disorder) that require treatment.

What is Anxiolysis?

Under one Anxiolysis medicine or psychiatry understands the resolution of fears. Chemical agents (psychotropic drugs) are usually used for this. They belong to different classes of active ingredients and are often referred to as minor tranquilizers (weak sedatives).

The main group of anxiolytics (anti-anxiety drugs) are the benzodiazepines. The tranquilizers / sedatives have a calming effect and dampen emotions, but are not without controversy because of their high potential for addiction and their various side effects. However, since many fears are based on psychological injuries that are not, only partially or inadequately processed, anxiolysis can only be successful if it is carried out in parallel with appropriate psychotherapy. Symptomatic treatment with anti-anxiety medication cannot in any case replace psychotherapy.

Depressed patients with anxiety symptoms are prescribed different drugs than people with phobias and those who suffer from schizophrenic psychosis. In certain cases, herbal remedies may also be given to those suffering from fears or phobias. In any case, however, cognitive behavioral therapy is essential. It is cause-oriented and gives the patient the tools of behavior he needs to deal appropriately with fear-inducing thoughts, people and situations.

Function, effect & goals

The administration of anxiolytics makes sense if the patient is already severely restricted in his lifestyle and possibly even has suicidal intentions. The main chemical agents prescribed include tranquilizers / sedatives, antidepressants, neuroleptics, and beta blockers.

Most anxiolytics have a balancing effect on the disturbed neurotransmitter balance. Other drugs (beta blockers) are not really anxiolytics, but are often prescribed because they reduce physical anxiety symptoms such as tremors, sweating, diarrhea, palpitations, etc. Tranquilizers are the most commonly administered. Benzodiazepines help against strong fears and panic states. They have a calming, anxiety-relieving, anticonvulsant and emotionally depressing effect and are effective within a short time. Commonly prescribed drugs of this type include oxazepam, alprazolam, and diazepam.

For depressed patients who also suffer from an anxiety disorder, the doctor prescribes antidepressants such as clomipramine, maprotiline or imipramine. They not only have a mood-enhancing effect, but also calming and emotionally shielding. In order to counteract any initial side effects, the antidepressants are given gradually. Therefore, they usually only achieve their optimal effect 2 to 3 weeks later.

In contrast to other anxiolytics, they are not very addictive and can therefore also be used for the long-term treatment of anxiety. Neuroleptics are mostly prescribed to schizophrenic patients because they block the transmission of dopamine at the synapses in the brain. Only low-potency neuroleptics such as Melperon and Promethazine have an anxiety-reducing effect. They dampen and relax so that the schizophrenic patient is capable of therapy.

Beta blockers reduce the physical symptoms of the anxiety disorder and also have an antihypertensive effect. However, they have no influence on the fears themselves and the associated irritability and nervousness. They do not reduce the patient's performance and do not have any addictive effect. Beta blockers are not used for long-term treatment. A thorough medical history and complete blood count must be performed before any chemical agents used for anxiolysis are administered. The drugs may only be prescribed by specialists in neurology and psychiatry and are usually dosed gradually and gradually in order to reduce the risk of side effects.

Most are taken once a day after breakfast or dinner, but some are taken twice a day. Sometimes there is an initial worsening reaction that subsides after a while. Herbal supplements can also be useful for less intense fears. If used as directed, they usually have no side effects. Valerian, St. John's wort, hops, chamomile, lavender and passion flower have proven effective in dealing with fears. The incensol contained in frankincense also has an anti-anxiety effect.

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Risks, side effects & dangers

The benzodiazepines in particular sometimes have severe side effects and are highly addictive, which can be seen after just a few days of use. Neuroleptics have side effects and even long-term effects that should not be underestimated, especially in long-term therapy. They also severely limit the patient's ability to react, so that he ideally refrains from participating in road traffic and operating machines.

In the absence of clinical studies, nothing can currently be said about the addiction potential of neuroleptics. In addition to the initial worsening effect, the following negative effects can occur when taking the substance groups: nausea, vomiting, digestive problems, restricted mobility and coordination disorders, damage to the detoxification organs, liver and kidneys, reduction or total loss of libido due to the sedating effect, weight gain by slowing down the metabolism up to obesity, hormonal disorders, reduced life expectancy with long-term use (not with beta blockers!), influencing the nervous system (tremors, nervous restlessness, sensory disorders in the limbs, sleep disorders) and cardiovascular problems such as tachycardia, hypotension and cardiac arrhythmia.

Sedatives can also lead to a habituation effect, so that the dose must be increased at intervals in order to achieve a constant effect. Since chemical agents prescribed for anxiolysis have been shown in animal experiments in breast milk, but no corresponding human studies are available, they should not be prescribed to pregnant or breastfeeding women. This applies in particular to the use of benzodiazepines.