Anxiolytics

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For over thirty years, benzodiazepines dominated the anxiolytic market and influenced clinical and animal research on anxiety. Many animal tests developed since the 1960s were optimized for benzodiazepines, often screening candidates based on their benzodiazepine-like side effects rather than their actual anxiolytic effects. However, the drawbacks of benzodiazepines, particularly their potential for tolerance and dependency, have sparked renewed interest in alternative anxiolytics. These alternatives include existing drugs like tricyclic and monoamine oxidase antidepressants, as well as newer agents like buspirone. Furthermore, anxiety is now understood as an umbrella term encompassing various specific disorders, such as panic disorder, generalized anxiety disorder (GAD), specific phobias, social phobias, and post-traumatic stress disorder (PTSD). This expanded understanding necessitates optimized treatments tailored to different anxiety syndromes. This critical review examines current anxiolytics and potential future options. While there are few satisfactory alternatives to benzodiazepines for acute anxiety, it is widely accepted that they are not the first choice for chronic anxiety. Alternatives such as tricyclics, monoamine oxidase inhibitors, serotonin reuptake inhibitors, and buspirone provide better options for chronic anxiety, though none are ideal.