Antianxiety medications can help reduce the symptoms of anxiety, such as panic attacks(disorder), fear, and worry. These medications can also be used to treat anxiety disorders.    

Introduction to Antianxiety Meds

Antianxiety drugs can be used as a primary therapy or with other treatments, such as psychotherapy, stress-relieving activities, and antidepressants. However, some antianxiety drugs can be habit-forming and should not be taken for long periods of time unless under the supervision of a health care provider (HCP).

Anxiolytics

Anxiolytics are a class of drugs that reduce anxiety by depressing the central nervous system. They also treat sleep disorders, alcohol withdrawal symptoms, and other conditions. 

The anxiolytics bind to the gamma-aminobutyric acid (GABA) to reduce hyperactivity in the brain and induce a calming effect. 

It then increases the influx of chloride ions and inhibits electrical activity in the brain, resulting in enhanced sedation. These medications can also decrease activity in the amygdala, which triggers human fear responses.

Anxiolytic Mechanism of Action

The potentiation and modulation of GABA receptors in the central nervous system.

Anxiolytics Side Effects

• Blurred vision
• Constipation
• Dry mouth
• Dizziness & drowsiness
• Fatigue
• Weakness
• Headaches

Anxiolytics Nursing Interventions

Monitor for sedation, respiratory depression, and interactions with other medications.

Encourage diet changes that will help reduce dry mouth or blurred vision while taking the drug.

Assist clients in finding ways to reduce dizziness or muscle weakness.

• Benzodiazepine anxiolytic examples are:
  • Lorazepam
  • Diazepam
  • Alprazolam
  • Clonazepam

Benzodiazepines

Benzodiazepines are a class of drugs that work on the central nervous system. They have a sedative and anxiolytic effect and are prescribed to treat anxiety, insomnia, and seizures. Benzodiazepines are a class of drugs that increase GABA receptors’ activity. 

Benzodiazepine Mechanism of Action

Elevating the seizure threshold by decreasing postsynaptic excitation. 

Benzodiazepine Side Effects

• Constant, involuntary movement of the eyeball (Nystagmus)
• Loss of control of voluntary movements, especially gait (Ataxia)
• Slurred speech
• Overgrowth of gum tissue (Gingival hyperplasia)

Benzodiazepine Nursing Interventions

Monitor anticonvulsant blood levels, even if the seizures are well controlled.

Avoid abruptly discontinuing medications, except when the health care provider (HCP) recommends them.

Encourage clients not to drive unless adverse reactions of drowsiness or dizziness are mild. The HCP will approve or reinstate driving privileges based on seizure control. Clients should also avoid the use of alcohol unless the primary health care provider has approved its use.

Barbiturates

Barbiturates are a class of drugs that act as central nervous system depressants. They have a wide range of uses, including anesthesia, seizure control, and pain management. Barbiturates work like benzodiazepines, but are stronger and have a more depressing effect.

Barbiturates are typically used to induce anesthesia and produce a controlled sleep state. They work by depressing the activity of the central nervous system, which causes reduced reflexes, slowed breathing and heart rate, and a decrease in blood pressure.

Barbiturate Mechanism of Action

Inhibiting the excitatory neurotransmitter glutamate at the NMDA receptor site, resulting in blocking calcium ion flux across the membrane.

Barbiturate Side Effects

• Drowsiness
• Dizziness
• Blurred vision
• Lethargy
• Slurred speech
• Impaired thinking

Barbiturate Nursing Interventions

Monitor clients for respiratory depression and hypotension.

Position clients in a sitting position to prevent aspiration pneumonia.

Administer naloxone if needed.

Buspirone

Buspirone works differently from other anxiolytics because it does not act on GABA receptors, but increases serotonin levels in the brain.

Buspirone is a drug that decreases the activity of certain chemicals in the brain called neurotransmitters. Buspirone is not effective for panic disorder, but it can be used in combination with other medications to treat generalized anxiety disorder (GAD).

Buspirone Mechanism of Action

Suppressing serotonergic activity while enhancing dopaminergic and noradrenergic cell firing.

Buspirone Side Effects

• Dizziness & drowsiness
• Difficulty sleeping
• Nausea
• Vomiting
• Diarrhea
• Headache
• Dry mouth

Buspirone Nursing Interventions

Monitor for signs of dizziness and nausea, and worsening of symptoms. Also, check blood pressure regularly.

Antianxiety Meds Conclusion

Antianxiety meds are used to treat anxiety, and can be taken alone or in conjunction with other therapies like psychotherapy and antidepressants. However, some anti-anxiety medications, like benzodiazepines, can cause addiction and should not be used for extended periods of time.

Anxiolytics are a group of medications that work by slowing down the central nervous system to lessen anxiety. Gamma-aminobutyric acid (GABA) has effects on the GABAA receptor sites in the brain, and these actions are enhanced by barbiturates and benzodiazepines.

Buspirone functions differently from other anxiolytics because it boosts serotonin levels in the brain rather than acting on GABA receptors.

Sources

https://www.healthline.com/health/anxiolytics 

https://www.benzoinfo.com/mechanism-of-action/ 

https://www.ncbi.nlm.nih.gov/books/NBK539731/ 

https://go.drugbank.com/drugs/DB00490