Tranquilizers: Therapeutic use
Last modified: Saturday, 20. June 2009 - 3:46 pm
Although the major and minor tranquilizers are used for their ability to depress CNS activity, these classes of drugs are used to manage a variety of specific symptoms and conditions.
Initially, the neuroleptics were used to manage severe anxiety, agitation, and aggression in individuals with severe mental illness such as schizophrenia, a psychotic illness characterized by delusions, hallucinations, and disorganized, illogical thinking. The first neurolep-tic used in schizophrenia was chlorpromazine (Tho-razine) in 1952. Additional neuroleptics were later developed to treat a variety of other disorders and conditions in children and adults, including autism, attention-deficit hyperactivity disorder (ADHD), bipolar disorder, and Tourette’s syndrome. Occasionally, these drugs are also used to manage severe pain.
BZDs such as chlordiazepoxide (Librium) or diazepam (Valium) may be prescribed to treat anxiety, seizures, acute stress reactions, and panic attacks, or to alleviate the side effects of drug or alcohol withdrawal. Those BZDs with a more sedating effect, such as estazolam (ProSom) or triazolam (Halcion), may be prescribed for short-term treatment of sleep disorders. However, the newer generation of non-BZD agents — zolpidem (Ambien) and (Sonata) — are less potentially addictive hypnotic drugs than the BZDs.
In addition to treating anxiety and insomnia, intravenous BZDs are used as a sedating agent in outpatient surgical procedures. The most commonly used BZD for this indication is the short-acting agent midazolam (Versed). There is a lower potential for respiratory suppression with midazolam than with the barbiturates.
Barbiturates such as mephobarbital (Mebaral) and pentobarbital (Nembutal), although not prescribed as often as the BZDs, may be used to treat anxiety, tension, and sleep disorders. Veterinarians also use pentobarbital (Nembutal) for anesthesia and euthanasia. In some states, a form of barbiturate is used to execute criminals by lethal injection.
The rapid-acting barbiturates, such as methohexital (Brevital), are used as intravenous anesthetics/induction agents. Advantages are rapid anesthesia and short duration of action. A disadvantage is respiratory suppression with higher doses.
Buspirone (BuSpar) is specifically formulated to reduce the symptoms of anxiety but takes two to four weeks to take effect. Adverse reactions include agitation, nausea, and dizziness.