Effect of tranquilizers. Tranquilizers - what are they, list of drugs. The effect of tranquilizers. Side effects and overdose

Tranquilizers are psychotropic drugs that are used to treat many diseases. Moreover, they are used not only in psychiatry, but also in oncology, neurology, surgery, dermatology, gynecology, narcology, etc. These funds have the following main effects:

• sedative;
• hypnotic;
• muscle relaxant;
• anticonvulsant;
• anti-anxiety.

Influencing the human body (mainly the central nervous system), these drugs help relieve emotional stress, reduce anxiety, irritability, get rid of fear and insomnia, reduce psychomotor excitability, etc. There are several types of tranquilizers, each of which is characterized by a different severity of action, intensity of properties and the ratio of effects produced. This is taken into account when choosing a drug for a particular patient. To date, the list of tranquilizers has more than a hundred drugs.

Classification of tranquilizers by generation

There are three generations of drugs in this group:

1. First generation tranquilizers:

• Meprobamate;
• Hydroxyzine;
• Benactizine, etc.

2. Second generation tranquilizers – benzodiazepine drugs.

3. Third generation tranquilizers:

• Buspirone;
• Oxymethylethylpyridine succinate;
• Etifoxine, etc.

The most common are second-generation drugs - benzodiazepines, which are divided into three groups according to the characteristics of the clinical impact:

1. Benzodiazepines with a pronounced anti-anxiety effect. Strong tranquilizers in the list of drugs in this group are:

• Diazepam;
• Lorazepam;
• Alprazolam et al.

Moderate effects are exerted by drugs such as:

• Gidazepam;
• Chlordiazepoxide;
• Bromazepam;
• Clobazam;
• Oxazepam, etc.

2. Benzodiazepines with a pronounced hypnotic effect. Drugs in this group are mainly used as sleeping pills. This list includes:

• Temazepam;
• Triazolam;
• Nitrazepam;
• Flurazepam;
• Flunitrazepam;
• Midazolam;
• Estazolam et al.

3. Benzodiazepines with a pronounced anticonvulsant effect. Intensive anticonvulsant effects are exerted by such drugs as:

• Clonazepam;
• Diazepam.

A lighter tranquilizer in the list of this group is Nitrazepam.

New generation tranquilizers

Buspirone, which is considered unique in neuropharmacology, occupies a special place in the list of new generation tranquilizer drugs. This remedy is effective in the treatment of mixed anxiety-depressive conditions, etc. Unlike drugs of the benzodiazepine series, Buspirone does not produce a sedative effect, a negative effect on psychomotor functions, does not cause addiction, drug dependence and withdrawal symptoms.

Etifoxine is also an effective and promising tranquilizer of the new generation. It is devoid of a significant number of disadvantages of benzodiazepines and has a selective effect on the body.

List of daytime tranquilizers

In a separate subgroup, daytime tranquilizers are distinguished, the list of which includes drugs with a predominant anti-anxiety effect and minimally pronounced sedative, hypnotic and muscle relaxant properties. Such funds are prescribed on an outpatient basis during the day and allow patients to lead their usual rhythm of life. It is classified as a daytime tranquilizer.

Tranquilizers (French tranquilliser - calm) - a group of psychotropic drugs that reduce fear, anxiety, anxiety, emotional tension. Both and constantly used in the treatment of various types of neurotic syndrome, psychasthenia, hypochondria, depression, autonomic dysfunction, mild and moderate manifestations of dyssomnia. In addition, other specialties widely use tranquilizers along with sedatives and antidepressants to normalize the emotional sphere, autonomic functions, which is often necessary in the treatment of patients of various profiles.

List of tranquilizers

Benzodiazepine derivatives

• Bromazepam
• Alprazolam
• Hydrazinocarbonylmethylbromophenyldihydrobenzdiazepine
• Diazepam
• Clonazepam
• Dipotassium clorazepate
• Lorazepam
• Medazepam
• Oxazepam
• Prazepam
• Tofisopam
• Bromodihydrochlorophenylbenzodiazepine
• Chlordiazepoxide
• Estazolam

Propanediol derivatives

• Meprobamate

Preparations of different groups

• Benactizine
• Benzoclidine
• Buspirone
• Hydroxyzine
• Tetramethyltetraazabicyclooctanedione
• Trimetozin
• Aminophenylbutyric acid

Mechanism of action, effects of tranquilizers

It is recognized that the basis of the action of tranquilizers is their influence on benzodiazepine receptors, discovered in the brain in 1978. These receptors are especially widely represented in the limbic system. Several variants of benzodiazepine receptors are known, and the interaction of individual tranquilizers with them is accompanied by a certain specificity of the resulting reactions. The function of benzodiazepine receptor subtypes ω-1, ω-2 has been most studied. Drugs that bind to ω-1 receptors have a significant hypnotic effect.

The discovery of benzodiazepine receptors made it possible to assume the existence of an anxiolytic (anti-neurotic) system and to begin an intensive search for selective carriers of regulatory information - ligands, as well as mediators that bind to certain benzodiazepine receptors. The result of such research was the realization of hopes for the discovery of new, effective tranquilizers and other psychotropic drugs that contribute to the treatment of mental and psychosomatic disorders.

Many drugs that have a tranquilizing effect are not registered (clobazam, dipotassium clorazepate, prazepam, estazolam, gindarine, trimetozin).

Pharmacokinetics of tranvilizers

All anxiolytics belong to lipophilic compounds and are almost completely absorbed. Some benzodiazepines, such as diazepam, have a particularly high degree of lipophilicity. Differences in the rate of absorption of drugs in the intestine are due to the fact that the time to reach their maximum concentration in the blood varies within 0.5-8 hours.

With the bloodstream, tranquilizers penetrate the blood-brain barrier (BBB) ​​into the brain, and the level of accumulation in the blood and cerebrospinal fluid soon practically levels off. In pregnant women, tranquilizers can cross the placenta, and in nursing mothers they pass into breast milk, where the concentration of drugs is approximately 10% of their content in the blood of the nursing mother.

Benzodiazepines are metabolized mainly by liver enzymes; Only dipotassium clorazepate and prazepam are metabolized primarily in the small intestine.

Excretion of most tranquilizers occurs through the kidneys in the form of metabolic products. Only about 1% of the drug is excreted unchanged.

Treatment with tranquilizers

To relieve panic attacks accompanied by cardiovascular and intestinal disorders (such as sympathoadrenal paroxysms, parasympathetic paroxysmal states), alprazolam and diazepam are used. For neurosis-like syndromes in patients with various somatic diseases, the same drugs are used, usually in small doses. Preferred are agents that do not cause pronounced sedation and significant muscle relaxant effects.

In severe psychosomatic diseases (in particular, peptic ulcer, hypertension, coronary heart disease), the use of tranquilizers is advisable if patients are in a state of emotional stress, for the purpose of premedication during various diagnostic and therapeutic procedures (for example, endoscopic examination, visiting the dentist).

For climacteric neurotic and autonomic disorders, tofisopam, as well as other tranquilizers, alone or in combination with hormonal therapy, have a good effect.

Tranquilizers are used in treatment during periods of confident abstinence from drinking alcohol, since there is parallel tolerance and cross-dependence between them, which makes it possible to temporarily “compensate” for the need for alcohol by prescribing large doses of tranquilizers.

In the initial stage of treatment of chronic alcoholism, tranquilizers are used to relieve “minor” withdrawal symptoms, usually manifested by increasing tremor, irritability, aversion to food and nausea. These symptoms occur soon (within a few hours) after stopping drinking alcohol and usually last up to 2 days. To relieve withdrawal symptoms, large doses of tranquilizers with strong anti-neurotic, vegetative-stabilizing and anti-anxiety effects are needed. Then it is necessary to achieve a pronounced sedative, hypnotic effect. For this purpose, chlordiazepoxide and bromod(phenazepam) are often used. In case of psychomotor agitation in the withdrawal stage, hydroxyzine is administered parenterally. Over the course of several days, the dose of tranquilizers is gradually reduced, while it is advisable to maintain a sufficient sedative or mild hypnotic effect for some time. At the same time, the patient is given detoxification and restorative therapy.

Further treatment of a patient with chronic alcoholism requires an integrated approach and differentiated psychotropic therapy, usually with the use of tranquilizers. In such cases, the selection of drugs and their dose depends on the nature of the underlying psycho-emotional syndrome. For asthenic and anergic syndromes, tranquilizers with a mild stimulating, antidepressant and/or strong vegetative-stabilizing effect are effective: medazepam, tofisopam; for anxiety syndrome - tranquilizers with a sedative effect: bromod(phenazepam), aminophenylbutyric acid (phenibut).

According to some data, in the complex treatment of patients with nicotine addiction, it is advisable to use tetra(mebicar) for 6 weeks.

When stopping a series of seizures, parenteral administration of diazepam or lorazepam is indicated.

Tranquilizers with additional anticonvulsant and muscle relaxant effects (for example, bromodihydro-chlorophenylbenzodiazepine - phenazepam, diazepam, chlordiazepoxide, aminophenylbutyric acid - phenibut) are also prescribed for various hyperkinesis: tics, blepharospasm, myoclonus, facial hemispasm and paraspasm, chorea, and tetose.

For restless legs syndrome and periodic movements during sleep, various benzodiazepine tranquilizers (diazepam, lorazepam, clonazepam) are used.

For pain syndromes (such as pseudoanginal pain, neuralgia, dental pain), the use of tranquilizers (for example, tofisopam, diazepam, bromod- phenazepam, tetra- mebicar) increases the pain threshold and often allows you to reduce the dose of the simultaneously used analgesic.

For functional cardialgia, tranquilizers with vegetostabilizing and anti-neurotic effects are indicated, in particular temazepam.

For pain syndrome with increased muscle tone, in particular, with local muscle tension in patients with destructive changes in the spine, damage to the musculo-ligamentous apparatus, arthrosis and post-traumatic reflex spasms, tranquilizers with a muscle relaxant effect are used: meprobamate, bromod(phenazepam), chlordiazepoxide, usually with analgesics.

When conducting kinesitherapy in patients with muscle tone and contractures, diazepam and chlordiazepoxide are prescribed in an average dose one hour before the start of the session. Similar treatment is carried out for convulsions and cramps.

Relief of psychomotor agitation in somatic patients, for example, with hemorrhagic strokes or traumatic brain injuries, usually begins with parenteral administration of diazepam, and if necessary, it is re-administered. With the development of severe psychomotor agitation during the recovery stage after a severe head injury, also in patients with metabolic disorders and drug intoxication, short-acting benzodiazepines, such as lorazepam, are used. Hydroxyzine and, less commonly, other tranquilizers with a sedative effect are also used. If the effect is insufficient, antipsychotics are used.

For itching in patients with dermatitis, vomiting or reactions, hydroxyzine is used.

As an additional remedy, tranquilizers are indicated for many diseases in the development or exacerbation of which increased psycho-emotional stress plays a role (for example, migraine, dysmenorrhea, muscular-tonic vertebrogenic syndromes).

When moderate neurotic disorders are combined with cough, benactizine, which has antitussive, antineurotic and anticholinergic activity, can be prescribed.

For premedication and in the postoperative period, hydroxyzine and aminophenylbutyric acid (phenibut) are used.

In elderly patients, tranquilizers without significant side effects are preferred: benzoclidine, diazepam, oxazepam, tofisopam in medium therapeutic and reduced doses. It should be noted that the metabolism of oxazepam does not change with age, so this drug can be prescribed at the usual dose. Elderly patients should be prescribed with caution drugs with pronounced sedative and muscle relaxant effects, in particular bromod(phenazepam).

For patients with increased psycho-emotional stress, whose work requires concentration and memorization, in some cases “daytime” tranquilizers are recommended: tofisopam, medazepam.

Course use of tranquilizers is indicated for neuroses, psychophysiological disorders, neurosis-like syndromes in somatic patients and for other conditions based on chronic increased psycho-emotional stress. Tranquilizers with a sedative effect are usually prescribed in the first days in minimal doses, with the patient taking most of the daily dose in the afternoon and at night. Gradually, over 4-7 days, the dose is increased to the therapeutic dose. In severe cases, immediately begin with a therapeutic dose; if necessary, it is administered parenterally. Tranquilizers with a weak sedative effect and a stimulating effect can also be prescribed, immediately starting with the intended therapeutic dose.

The duration of taking the optimal therapeutic dose depends on the severity of psycho-emotional disorders and averages 2 weeks with a gradual reduction in the dose and discontinuation of the drug. The gradual withdrawal of tranquilizers when taking large doses of drugs with a short half-life is especially important to prevent withdrawal syndrome. Long courses of treatment with tranquilizers lead to the development of tolerance, which is characteristic of most drugs in this group, therefore, if further treatment with them is necessary, it is recommended to take breaks or replace the tranquilizer used with another one that is similar in pharmacological parameters, but preferably with a relatively shorter half-life. It is usually possible to return to the previous drug after 4-6 weeks.

In situations that contribute to the exacerbation of the patient’s neurotic disorders, a preventive course of treatment with the most suitable tranquilizer in the optimal dose for 1-2 weeks is advisable. Periodic use of tranquilizers is indicated, in particular, for patients with severe psychosomatic and other diseases, the exacerbation of which can be provoked by a stressful situation, or in cases where a psycho-emotional reaction is a consequence of an exacerbation of a somatic illness.

Typically, patients with symptoms of emotional overstrain in the event of upcoming unpleasant or painful diagnostic or therapeutic manipulations the night before, before bedtime, are prescribed a tranquilizer with a hypnotic effect, and 2 hours before such manipulation, one or two average therapeutic doses of a drug with a pronounced anxiolytic, tranquilizing effect are administered: diazepam , lorazepam, clonazepam. In addition, parenteral administration of chlordiazepoxide is sometimes advisable.

Tolerability, side effects of tranquilizers

An overdose of tranquilizers or their excessively long-term use sometimes leads to drug intoxication, which is characterized by headache, dizziness, nystagmus, diplopia, dysarthria, dyspepsia, leukopenia. In such cases, it is advisable to gradually reduce the dose of the drug.

Toxic reactions rarely accompany treatment with tranquilizers. Typically, intoxication is more pronounced in older people, with liver disorders, a combination of treatment with tranquilizers, taking other psychotropic drugs that depress the central nervous system, and drinking alcohol. Therefore, when prescribing tranquilizers to older people, treatment should begin with a small dose, followed by a gradual increase to a sufficient therapeutic dose, which is usually significantly lower than the average.

With prolonged courses of treatment with tranquilizers from the group of benzodiazepines with a long half-life, cumulation of the drug and accumulation in tissues is possible, which happens when the interval between doses of the drug is less than 24 hours. In such cases, the possibility of drug intoxication increases, especially in elderly patients. In this case, it is possible to develop anemia, leukopenia, dyspepsia, the appearance of headache, dizziness, and less often psychomotor agitation and delirium, which disappear after discontinuation of the drug. Severe acute or chronic intoxication with tranquilizers can lead to stupor and the need for resuscitation. Long-term parenteral administration of benzodiazepines leads to an increase in the activity of creatine phosphokinase (CPK) in the blood, which must be kept in mind when considering the likelihood of a patient having a myocardial infarction. Intravenous administration of benzodiazepines causes phlebitis in approximately 4% of patients.

In approximately 1% of patients taking tranquilizers, the development of paradoxical neurotic reactions was noted: psychomotor agitation, emotional irritability, anger, tears and similar manifestations, which are usually associated with genetically determined metabolic characteristics.

Poor tolerance to tranquilizers is sometimes (rarely) manifested by allergic reactions (such as itching, urticaria), usually requiring withdrawal or replacement of the drug.

Of the side effects when using tranquilizers of the benzodiazepine group, respiratory failure, paradoxical reactions with anxiety and changes in consciousness (more often in patients with organic damage to the central nervous system) deserve special attention. Such patients tend to develop tolerance, and sometimes mental or physical dependence. In the latter case, if the drug is quickly discontinued, withdrawal syndrome may develop, more often when treated with benzodiazepines with a half-life of less than 24 hours.

There is an opinion about the possible teratogenic effect of benzodiazepines, especially when taken in the first trimester of pregnancy.

Contraindications for tranquilizers

First of all, use is contraindicated in case of hypersensitivity, as well as to their components (or to any drug of the same chemical group). The first trimester of pregnancy is also considered a contraindication to the use of all tranquilizers.

Preparations with significant sedative and musorelaxing effects, such as Benactisine, bromazepam, hydroxyzine, clobase, lorazepam, meprobamate, themezepam, bromdihy(phenazepam), aminophenil-oil acid (phenybut), chlordiasis-podsid. Steniya and with respiratory failure. In these conditions, daytime tranquilizers are used with caution, which also sometimes cause a muscle relaxant effect.

The use of benactizine, hydroxyzine, medazepam and other tranquilizers that have a pronounced anticholinergic effect is contraindicated for glaucoma and prostate adenoma. When prescribing alprazolam, lo-razepam, diazepam, chlordiazepoxide, oxazepam, caution and control of intraocular pressure are necessary, since these drugs provoke an increase in the secretion of aqueous humor of the eye and an increase in intraocular pressure.

In case of organic diseases of the central nervous system, it is necessary to avoid the use of lorazepam, dipotassium clorazepate, alprazolam, the possible side effects of which are due to a pronounced effect on the structures of the central nervous system and their functions.

If the patient is prone to drug abuse, especially in drug addiction and chronic alcoholism, tranquilizers with a long half-life, to which dependence often develops (alprazolam, clobazam, lorazepam, medazepam, meprobamate, tofisopam, trimetozin, estazolam), should not be prescribed.

The use of all tranquilizers is contraindicated for persons whose activities require attention, quick and adequate reaction (for example, transport drivers, air traffic controllers).

Benzodiazepines are contraindicated in the treatment of pregnant women.

Cautions

Since tranquilizers pass into the milk of a nursing mother, their use during the period of feeding a child should be avoided. Care must be taken when prescribing tranquilizers to patients when the work requires quick decisions and motor reactions.

Interaction

Tranquilizers are undesirable to combine with antidepressants monoamine oxidase inhibitors. In addition, benzodiazepine derivatives. meprobamate induce enzymes that metabolize phenytoin, glucocorticoids, anticoagulants, oral contraceptives and, therefore, may lead to a decrease in their effectiveness.

The simultaneous use of diazepam, bromd(phenazepam) and antiepileptic drugs (phenobarbital, carbamazepine, phenytoin, valproate) leads to mutual potentiation of their action. Tranquilizers enhance the effect of sedative and hypnotic drugs, neuroleptics.

Tranquilizers from the group of benzodiazepine derivatives with an anticholinergic effect in combination with anticholinergic agents (for example, ganglion blockers, trihexyphenidyl) can aggravate the side effects of the latter.

Chlordiazepoxide and diazepam enhance the effect of antiarrhythmic drugs, lidocaine.

Spironolactone and phenobarbital can activate the metabolism of benzodiazepines. Cimetidine and oral contraceptives inhibit the metabolism of diazepam, chlordiazepoxide, temazepam, oxazepam, lorazepam.

All tranquilizers, except tofisopam, reduce tolerance to alcohol, and their combination with alcohol can lead to unpredictable reactions.

The article was prepared and edited by: surgeon

The word tranquilizer means to calm down. These drugs differ from sedative drugs because they have a harsher effect. If sedatives try to help induce sedation, then the action of tranquilizers is characterized by the performance of a sedative effect. This conclusion can be drawn from the very names of these two groups.

Among psychotropic drugs, tranquilizers occupy the second position in terms of the strength of the psychotropic effect and the level of side effects, immediately after sedatives, which, for the most part, are herbal medicines.

Tranquilizers classification.

There are more and more questions about the classification of tranquilizers every day. After all, new drugs are constantly appearing that do not fit into any of the known groups.

The largest and most used group is benzodiazepine derivatives (BDT), :
phenazepam, diazepam (Relanium, Sibazon, Seduxen, Valium), gidazepam, chlordiazepoxide (Elenium), alprazolam (Xanax), medazepam (Rudotel), nozepam, lorazepam and etc.
The most powerful tranquilizers in this group are phenazepam and lorazepam.

The remaining tranquilizers are either similar in chemical structure to BDT, or have parts of BDT in their chemical structure.
The less they resemble BDT, the weaker they are and have less hypnotic and relaxing effects, and the overall side effect increases and the price of the drug increases.

The drugs closest to the group of BDT derivatives are those that doctors classify as a separate clinical group - daytime tranquilizers. They do not cause drowsiness and lethargy, but their effect is much weaker than phenazepam.
This gidazepam, medazepam, oxazepam, grandaxin (tofisopam). These medications do not cause lethargy and can be used when performing work that requires increased attention.

There are also tranquilizers, which are classified as derivatives of various chemicals. This grandaxin, mebicar, oxylidine, trioxazine.

There are also new tranquilizers that do not cause dependence, addiction and drowsiness: a diphenylmethane derivative - atarax, a 2-mercaptobenzimidazole derivative - afobazole, a urea derivative - and others. As tranquilizers, they are very weak, have side effects on the autonomic nervous system (dry mouth, nausea, vomiting, diarrhea), and the price is again very high. These drugs show their therapeutic effect in a very small number of cases. But, despite this, the absence of addiction and tranquilizer withdrawal syndrome in these drugs gives them the right to life.
Each of the tranquilizers has a huge number of different names (synonyms), so you need to read the instructions carefully.

Tranquilizers use.

These medications are used for various neuroses and psychopathic conditions in which anxiety, panic, fear, increased irritability and emotional instability are observed. Also used for psychosomatic disorders.
Most of the drugs in this group are undesirable for the treatment of weakened and elderly patients, children under 18 years of age. The use of tranquilizers is contraindicated for pregnant women (especially in the early stages), under alcohol and drug intoxication, kidney and liver failure, and when performing work that requires a quick reaction (driving).

The question of choosing a drug from the group of tranquilizers for treatment must be decided by the doctor together with the patient. My advice is that if you begin to include tranquilizers in your treatment, you should try to start with the weakest, and not with the strongest. It is necessary to take into account all the advantages and disadvantages of medications, as well as concomitant diseases and age. Many people start taking the powerful drug phenazepam, on the advice of friends or neighbors, in situations where it would be possible to undergo treatment with sedatives.

Tranquilizers have a bad reputation among the population, they say that only drug addicts take them. This is a very erroneous and incorrect opinion. You need to know that tranquilizers are powerful drugs, but they are not drugs.

But fear and bad prejudices about taking tranquilizers among the population exist and are significant. Therefore, recently, drugs from this group began to be called by new, fashionable and incomprehensible names for a wide range of common people. Today you can hear the name anxiolytics, which means - dissolving fear and anxiety, or anti-neurotics - aimed against neurosis. But these are all tranquilizers.

Medicines included in this group and used in therapeutic doses reduce fear, panic and anxiety. Their main difference from neuroleptics, even more powerful drugs than tranquilizers, is that tranquilizers have no effect on delusions, hallucinations and other manifestations of psychosis, for example, in schizophrenia. They help only mentally healthy people who are temporarily under the influence of an unfavorable environment.

Mechanism of action of tranquilizers not fully studied. The bulk of these drugs are benzodiazepine derivatives (BD). They contain substances that affect nerve endings in the human body that sense the presence of benzodiazepine in the connections between nerve cells (benzodiazepine receptors).

Until now, scientists argue on this topic. Why do the human body have such benzodiazepine receptors?
There is an opinion that as a result of some kind of breakdown in the human body, there was simply a shortage of a certain substance. For normal operation of all systems you need to add a little of this substance. Such substances in the smallest doses are tranquilizers.

Why such a breakdown happens and where no one today knows and can prove it. It is believed that this occurs in the limbic part of the brain, where tranquilizers have their effect. But these are just assumptions.

Tranquilizers help a mentally healthy body calm down and regain a normal general state when exposed to acute or chronic stress. When you are faced with a difficult life situation and you are constantly “on pins and needles,” they give the nervous system an opportunity to calm down. If it were not for these medications, the nervous system during acute stress may break down from overstrain, which can lead to the development of psychosis and mental illness.

Effect of tranquilizers very fast and efficient. It begins a few minutes after taking the medicine, and the peak effect occurs after 30-60 minutes, depending on the drug. But it does not last long, only a few hours. Therefore, regular appointments are required for 2-6 weeks, and in some cases treatment is continued longer. Treatment begins with a dose that completely removes all unpleasant symptoms in a few days. Then the dose is gradually reduced to one that will reliably maintain the achieved effect.

In addition, tranquilizers have the property of cumulation (accumulation in the body), that is, they are removed from the body for a long time. When you start treatment and take the medicine regularly, they accumulate in your body. Their main effect and maintenance of normal functioning of the body can last for several days, even with abrupt withdrawal of tranquilizers. Only when the level of medication in the body drops below the required level, and this may be on the 2-5th day of withdrawal, all symptoms may return. This condition often occurs when, after being treated for a week or 10 days, and seeing that all the symptoms of anxiety and panic have passed, you decide that you are completely healthy and stop taking the medicine.
This should not be done under any circumstances. Treatment should continue the full course prescribed by the doctor. If you find yourself in such a condition for the first time, then the success of VSD treatment depends on the strength of the cure for such a primary condition. You can't experiment here. These medications calm the body and give it time to forget the event that caused anxiety and panic. After all, the body can accept this anxiety disorder that you have fallen into as the norm of its existence, and then the consequences are unpredictable.

Tranquilizers act here as vegetable stabilizers, (normalize the functioning of the autonomic nervous system and internal organs of a person). They help your body quickly return to its usual routine of life and make it possible to remember a normal state that was disrupted by stress.

Their main effect is tranquilizing or anti-anxiety. In addition, tranquilizers provide a sedative and hypnotic effect, as well as relax muscles and have an anticonvulsant effect. All tranquilizers have these effects, but to varying degrees. Each drug has more pronounced one or more of them.

Tranquilizers side effects.

Tranquilizers have virtually no side effects on the heart and other body systems that are inherent in antipsychotics and antidepressants. You only need to observe the dose and duration of use.

If you take tranquilizers for up to a month and in therapeutic doses, symptoms of inhibition of the central nervous system may be observed, which disappear after cessation of treatment. The side effects of phenazepam, lorazepam and diazepam, like the most powerful benzodiazepine tranquilizers, are most pronounced.

These include decreased attention, drowsiness, poor coordination of movements, fatigue, dizziness, and decreased blood pressure.

With longer use, there may be a decrease in visual acuity and sexual desire, muscle weakness, asthenia, disruption of the blood count and normal liver function with damage to its tissues. But all of the above, of course, completely depends on the dose of the medicine and the duration of treatment.

These are emergency medications and are not intended for long-term use. But with prolonged use, more than one month and doses exceeding the average therapeutic value, tranquilizers can cause addiction, drug dependence and withdrawal symptoms. Addiction, not in the sense that you will get used to the medicine and want to take it constantly, but in the sense that your body will stop responding over time to the dose offered to it. And this dose will need to be increased. This can happen even when drugs are used in therapeutic doses.

The main thing is the result. And the result is that a person, after taking a course of tranquilizers, returns to normal life. The course of treatment lasts from two to six weeks. Then, after stabilization of the patient’s mental state and the autonomic nervous system, the drugs are discontinued. But not sharply, but gradually, over several weeks, gradually reduce the dosage. All misfortunes in this treatment are due to the ignorance of the patient and the doctor.

Therefore, a situation often occurs when a sharp withdrawal of tranquilizers, also causes the return of symptoms of VSD.
There are two ways here.

The first is to take drugs from stronger groups, such as antipsychotics and antidepressants.

Or go the other way, which is not very welcomed by doctors, but is used all the time among the people. Namely, use a tranquilizer, for example alprazolam, gidazepam, diazepam or phenazepam, in a small maintenance dose constantly. The fact is that with this use, the dose of the tranquilizer does not increase over time. That is, there is no main sign of drug dependence such as addiction to the drug and a constant increase in dose.
Then, after the condition has confidently stabilized, after several months or years, a person can try a very moderate and gradual dose reduction to cancel the tranquilizer and switch to weaker sedative medications.

Most tranquilizers reduce attention and lengthen a person’s response time to changes in the situation. They may cause drowsiness and slight weakness. Therefore, driving a car or other vehicles is prohibited. This must be taken into account when combining treatment with tranquilizers with work that requires a quick and accurate response. You cannot combine alcohol and tranquilizers. Alcohol enhances the effect of medications, which can lead to tragic consequences.

Tranquilizer sleeping pills It has an effect, but this is not its main effect. It is considered a huge mistake to prescribe and use a tranquilizer to obtain a hypnotic effect. Yes, it will help you fall asleep, and it will do it quickly, but then it will be very difficult to cancel it. Indeed, when used as a sleeping pill, tranquilizers are very often addictive with drug dependence. There are sleeping pills to combat insomnia.

I agree that tranquilizers are not simple drugs. They belong to psychotropic drugs, and their action is unpredictable. But from several evils, one must choose the one that is less. My opinion is this.

But you must understand that psychotropic drugs affect a person as an individual and create a new perception of the surrounding reality. Therefore, treatment of VSD must necessarily involve your direct participation in the prescription and use of medications. After all, only you yourself can determine whether this particular medicine helps you and what side effects it has.

You can watch the film “Psychiatry: Industry of Death” and draw your own conclusions from what you see.

Tranquilizers, the list of drugs of which will be presented below, are means for relieving causeless fears, anxiety, and tension. They do not impair cognitive functions. If we compare tranquilizers with antipsychotics and antidepressants, they are not able to eliminate hallucinations, delusions, fight depression and other similar manifestations.

But tranquilizers are characterized by anticonvulsant effects, they promote muscle relaxation and exhibit an autonomic stabilizing effect.

Most of these drugs are used for short-term treatment, since long-term use of the drugs leads to addiction. In new generation drugs belonging to the group of tranquilizers, such an effect is either greatly reduced or completely absent.

The list includes the following popular drugs:

1. Elenium (chlordiazepoxide, librium) is a tranquilizer of the benzodiazepine series. This remedy affects the patient, relieving his anxiety, producing muscle relaxation. Used to cure neuroses, various obsessive states, to eliminate panic attacks and emotional stress. It is administered orally.
2. Valium (diapazetam, relium, seduxen) - has the same properties as Elenium. Eliminates all types of anxiety during neurosis, eliminates insomnia and panic attacks, obsessions in the presence of rituals. Used to treat Gilles de la Tourette syndrome, normalizes and stabilizes nighttime sleep, and can be used to combat epilepsy. Available in the form of tablets or solution for intravenous and drip use.
3. Lorafen (lorazepam) - belongs to a group of drugs that have the ability to cope with various phobias, and at the same time have a hypnotic effect. The drug is effective in the fight against all types of neurosis, in the treatment of hypochondriacal and senestopathic conditions, stabilizes the work of the autonomic nervous system.
4. Bromazepam (lexomil, lexotane) - belongs to the group of drugs that have a significant sedative effect. It is used in the elimination of panic attacks, normalizes and stabilizes sleep in various neuroses. This medication is not as effective in eliminating obsessive disorder in the presence of rituals.

General purpose medicines

These include the following medications:

1. Phenazepam is a medicine that is produced in Russia. It has a wide range of effects, it can be attributed to the group of highly active tranquilizers. It surpasses such a drug as Seduxen in anxiolytic effects - it relieves convulsions, conducts muscle relaxation. Doctors prescribe phenazepam during a neurosis, psychopathic or similar condition, which may be accompanied by anxiety, fear or high irritability. This medicine is also effective for emotional lability. These properties allow the use of Phenazepam in the treatment of a protracted hypochondriacal state during various diseases of a somatic nature. Normalizes sleep in patients suffering from unreasonable anxiety, cures various obsessive conditions. Available in tablet form.
2. Atarax (hydroxyzine) is a medicine that can be used for a long period, as it is not addictive. Used in the treatment of mild phobias and asthenia. Available in the form of tablets or syrup. This remedy effectively corrects disorders of the autonomic system, treats various somatic disorders, eliminates the patient's sensations of heat, hot flashes. Can eliminate shortness of breath if it is neurogenic in nature. Cures sweating, dizziness of various types, nausea.
3. Frisium (clobazam) - has a powerful anticonvulsant effect. The drug is as effective as other anxiolytics. Eliminates acute feelings of anxiety and fear during panic attacks of varying strength. Used to cure neuroses. Taken orally.
4. Alprozolam (Xanax) is an effective drug that is most often used to relieve severe panic attacks in patients. It can stabilize the functioning of the autonomic system. It is absorbed into the blood very quickly, and the active substance reaches its highest concentration in the blood plasma after 2 hours. Taken orally.
5. Oxylidine - unlike many of the above medications, does not belong to the benzodiazepine group. It has a moderate effect on the patient and calms the nervous system, relieves hypertension. The medication can significantly enhance the effect of various sleeping pills on patients and has a good effect on blood circulation in the brain structures. Taken orally. The course of therapy lasts up to 2 months.
6. Halcion (triazolam) is a short-acting medication. It is mainly used as a sleeping pill, as it quickly calms patients and induces sleep.

Side effects

The following types of side effects caused by the medications presented above are known:

• increased drowsiness occurs;
• muscle weakness appears;
• concentration is impaired;
• mental reactions are inhibited;
• sometimes dysarthria or tremor appears.

The following reactions are possible from the autonomic system:

• development of hypertension.
• constipation and urinary incontinence.
• often - weakening libido.

Rarely, problems with the respiratory center were observed, which sometimes ended in a complete stop of breathing. Therefore, you cannot take these medications for a long time.

... an intensive search for new drugs that have an anxiolytic effect and at the same time are safer and more effective than existing drugs continues.

Tranquilizers(from Latin tranquillium - “calmness”) are one of the most important groups of psychotropic drugs. Recently, they are increasingly called anxiolytics (from the Latin anxius - “anxious” and the Greek lysis - “dissolution”).

Tranquilizers- this is a special group of psychotropic drugs that reduce or eliminate fear, anxiety, restlessness, irritability, emotional tension, the severity of emotional intensity of experiences, that is, they have an anti-neurotic effect.

Indications for prescribing tranquilizers: in addition to a wide range of psychopathological conditions of a neurotic level (fear, tension, anxiety), there may be states of alcohol withdrawal, status epilepticus, petit mal seizures and infantile spasms, insomnia and other sleep disorders, muscle spasms and dystonia, dyskinesias caused by antipsychotics. Intravenous administration of large doses of tranquilizers can cause a distinct sedative effect even with psychomotor agitation. Together with antipsychotics and lithium, they help relieve manic agitation. In other areas of medicine, tranquilizers are used as adjuncts in electrical pulse therapy of cardiac arrhythmias, during endoscopies and bronchoscopy, to enhance analgesia during childbirth, and as a means of preoperative sedation (premedication).

Among psychotropic drugs, tranquilizers are the most widely used in both inpatient and outpatient treatment. The scope of their use goes far beyond psychiatry, covering somatic diseases, neurology, surgery, anesthesiology, oncology, dermatology, gerontology, pediatrics, addiction medicine and, of course, obstetrics and gynecology. This demand for tranquilizers is also confirmed by the fact that since the development of the first drugs with tranquilizing properties, today their group includes more than 100 drugs and active work is still ongoing to create new ones and improve existing ones.

The widespread use of tranquilizers in clinical practice is also facilitated by the fact that, in general, unlike other psychotropic drugs (neuroleptics, antidepressants), they are characterized by the absence of severe side effects and good tolerability. But despite this, there is a certain list of the main adverse effects of tranquilizers, such as hypersedation (dose-dependent daytime sleepiness, decreased wakefulness, impaired coordination of attention, forgetfulness), muscle relaxation (relaxation of skeletal muscles, manifested by general weakness, weakness in certain muscle groups), “behavioral toxicity” (mild impairment of cognitive functions and psychomotor skills, manifested even in small doses and detected during neuropsychological testing), etc., which make doctors of various specialties increasingly pay attention to such a subgroup of tranquilizers as “daytime tranquilizers”.

“Practical Medicine” realized the need for drugs from the group of “daytime tranquilizers”, which have a pronounced anxiolytic effect, but do not cause certain sedative effects (muscle relaxation, impaired coordination of movements and operant activity, drowsiness, etc.) in therapeutic doses. This is especially true for patients who continue to lead an active lifestyle during treatment, sometimes associated with driving vehicles* or working with dangerous mechanisms*, or at heights*, as well as in patients with quite severe concomitant somatic pathology (requiring the exclusion of sedatives and muscle relaxants). effect of drugs).

The following “daytime” tranquilizers are distinguished (E.I. Gusev, A.S. Nikiforov, A.B. Gekht, 2003): (1)* “daytime” tranquilizers that do not have a pronounced sedative effect: gidazepam, prazepam, and also (2) “daytime tranquilizers” that have a mild stimulating effect: mebicar, medazepam, trimetozin, tofisopam. Let's take a closer look at each of these drugs (some authors include daytime tranquilizers and tazepas, alprazolams, as well as phenibut, but they will not be discussed in this article).

* “Daytime” tranquilizers, despite the fact that they do not cause a significant decrease in the ability to concentrate, should be used with caution during work by vehicle drivers and people whose profession is associated with increased concentration.

!!! The question of the ability to drive vehicles is decided after assessing the patient’s individual response to the drug.

Gidazepam(Hydazepam)

“Daytime” anxiolytic drug of the benzodiazepine series (1,4-benzodiazepine derivative). Pharmacological action - anxiolytic. It has an activating effect, vegetative stabilizing properties, and a mild muscle relaxant and hypnotic effect. There is evidence of positive effects on the cardiovascular system in patients with neurological conditions and in healthy people in stressful situations.

Indications for use: neurotic and neurosis-like states, accompanied by anxiety, fear, irritability, emotional lability, insomnia; psychopathy; autonomic lability (including diencephalic pathology); migraine, logoneurosis; in narcology: alcohol withdrawal syndrome, alcoholism (complex treatment); maintenance therapy during remission in patients with alcoholism.

Directions for use and doses. Available in tablet form of 20 mg and 50 mg. Orally, 20–50 mg 3 times a day, gradually increasing the dose. The dosage regimen and duration of treatment are selected individually depending on the indications, the patient's condition, and drug tolerability. Average daily dose for neuroses: 60–200 mg, for migraines and logoneuroses: 40–60 mg, for alcohol withdrawal: 150 mg. Highest daily dose for alcohol withdrawal: 500 mg.

Medazepam(Medazepam)

Trade names with the active ingredient medazepam: mezapam (tablets of 10 mg and granules for children in a package of 2 mg), nobritem (capsules of 5 mg), rudotel (tablets of 10 mg), nobrium.

“Daytime” anxiolytic agent (1,4-benzodiazepine derivative). Has a pronounced anxiolytic effect. Sedative, hypnotic, central muscle relaxant and anticonvulsant effects appear to a lesser extent. Eliminates anxiety, fear, psychoneurotic tension, motor restlessness, excessive fussiness. Restores a critical assessment of one's own condition. Stabilizes vegetative functions. Relieves symptoms of acute alcohol withdrawal.

Indications for use: neuroses, psychopathy, neurosis-like and psychopath-like states, accompanied by increased excitability, irritability, emotional lability, decreased mood, tension, anxiety, fear; psychovegetative and psychosomatic disorders, incl. vegetative-vascular dystonia, sleep disorders, functional disorders of the cardiovascular system and gastrointestinal tract, migraine (prevention of attacks), menopausal syndrome.; in pediatric practice: mental lability and excessive excitability in children, “school” neuroses; in narcology: alcohol withdrawal syndrome (uncomplicated), complex therapy of delayed neurotic disorders developing in the structure of remission of alcoholism and drug addiction.

Directions for use and doses. Inside. The dosage regimen is set individually depending on the indications, course of the disease, tolerability, etc. Treatment should begin with the lowest effective dose, the daily dose is divided into 2-3 doses, if necessary, increasing the daily dose is recommended by increasing the evening dose. Average doses for adults: single - 10 - 20 mg, average daily - 20-30 mg, maximum - 60 - 70 mg/day. At the beginning of treatment - 5 mg 2 - 3 times a day, then the dose is gradually increased to 30 - 40 mg per day. In outpatient settings, 5 mg is recommended in the morning and afternoon and 10 mg in the evening. Elderly patients, adolescents, as well as those with impaired renal function - 5–10 mg 1–2 times a day or 10 mg at night. For children, the dose is calculated depending on age and body weight. The duration of treatment should be as short as possible (approximately 2 weeks) and should not exceed 2 months (including the period of gradual reduction of the drug dose). Before repeating the course, the break should be at least 3 weeks. When treating alcoholism, 30 mg/day is prescribed for 1–2 weeks.

Tofisopam(Tofisopam)

“Daytime” anxiolytic drug, an atypical diazepine derivative (2,3-benzodiazepine). Trade name Grandaxin (50 mg tablets).

Indications for use: neuroses and neurosis-like conditions; conditions accompanied by emotional stress, autonomic disorders, moderate fear, apathy, decreased activity, obsessive experiences; reactive depression with moderately severe psychopathological symptoms; post-traumatic stress disorder; mental adjustment disorder; cardialgia (alone or in combination with other drugs), menopausal syndrome (as an independent remedy, as well as in combination with hormonal drugs); premenstrual tension syndrome; myasthenia gravis, myopathies, neurogenic muscle atrophy and other pathological conditions with secondary neurotic symptoms, when anxiolytics with a pronounced muscle relaxant effect are contraindicated; in narcology: alcohol withdrawal syndrome, delirious states (to relieve agitation and vegetative symptoms), opium withdrawal syndrome and post-withdrawal state; neurotic, psychopathic disorders in alcoholism, as well as conditions characterized by apathy and decreased activity in alcoholism.

Directions for use and doses. Inside. The dosage regimen is set individually depending on the indications, the patient’s condition, and drug tolerability. Single dose - 50 - 100 mg, average daily dose - 150 - 300 mg in 1 - 3 doses, maximum - 300 mg / day for 4 - 12 weeks, including the time of gradual withdrawal of the drug. In elderly people and patients with renal failure, the dose is reduced by 2 times.

Trimetozin(Trimetozinum)

The active ingredient is 4-(3,4,5-Trimethoxybenzoyl)-morpholine (also included in drugs such as sedoxazine, trioxazine).

It has a moderate tranquilizing effect, combined with activation and a slight increase in mood without drowsiness and intellectual inhibition. It does not suppress mono- and polysynaptic reflexes, and therefore does not have a muscle relaxant effect.

Indications for use. Used for neurotic disorders that occur with a predominance of hyposthenic manifestations (adynamia, lethargy, lethargy). Trimetozin is generally well tolerated and can be used in inpatient and outpatient settings. When taking relatively large doses, weakness, lethargy, mild nausea, drowsiness, and in some cases allergic reactions, dyspepsia, dry mouth and throat may occur. Rarely there is an increase in anxiety, tension, and fear. With long-term use of trimethosine (as well as other tranquilizers), mental addiction may develop.

Directions for use and doses. The drug is prescribed orally (after meals), usually 300 mg (1 tablet) 2 times a day. For mild neurotic conditions, the daily dose can be 600 - 900 mg (1 tablet 2 - 3 times a day), and for severe symptoms, increase the dose after 3 - 4 days to 1.2 - 1.8 g per day (total 4 - 6 tablets; in some cases the dose can be increased to 10 tablets per day). Children are prescribed in smaller doses according to age - 1/2 tablet up to 3 - 5 times a day).

Prazepam(Prazepam)

Trade name: Demethrin. “Daytime tranquilizer” has anti-neurotic, anti-anxiety, antiphobic, vegetative-stabilizing effects. However, in therapeutic doses it does not cause sedation or muscle relaxant effects and usually does not have a significant effect on the speed of reactions.

Prazepam has a wide range of indications, providing a good effect in various neurotic, psychophysiological, psychosomatic disorders, and with withdrawal syndrome in patients with chronic alcoholism. Available in tablet form of 10 mg. Directions for use: adults, orally: 10 mg 3 times a day or 20 - 40 mg 1 time a day at night.

Mebicar(Mebicar)

Active ingredient: tetra(also included in drugs such as adaptol; mebix).

Anxiolytic agent (anxiolytic, tranquilizer) with properties of nootropics, antidepressants, biocorrectors, adaptogens, lipid-lowering and antianginal agents. Experience with the use of Mebicar in the treatment of mental disorders has shown that the drug has the properties of a daytime tranquilizer and has nootropic activity. The tranquilizing effect is not accompanied by muscle relaxation and impaired coordination of movements. Mebicar is better tolerated than benzodiazepine tranquilizers: it does not cause emotional dullness, decreased initiative and activity, deterioration of attention and memory, lethargy, muscle relaxation, drowsiness, etc. In addition to moderate tranquilizing activity, Mebikar also has anticonvulsant activity. Mebicar mainly acts on the serotonergic system of the body. In small and medium doses, Mebicar enhances the effect of the serotonin precursor tryptophan. Mebikar is applicable not only as a tranquilizer, but also as an antidepressant.

Indications for use: neuroses and neurosis-like conditions, incl. in patients with alcoholism during remission; mild hypomanic and anxiety-delusional states without gross behavioral disturbances and psychomotor agitation; residual states after acute psychosis with symptoms of affective instability and residual productive symptoms; chronic verbal hallucinosis of organic origin; stress disorders in people working under extreme professional stress (prevention and treatment); cardialgia (not associated with ischemic heart disease); IHD and rehabilitation after myocardial infarction (complex therapy); nicotine withdrawal (as part of complex therapy; to reduce the desire to smoke); reducing craving for psychoactive drugs; to improve the tolerability of neuroleptics and tranquilizers.

Directions for use and doses. Mebicar is available in tablet form of 300 mg. Mebicar is usually prescribed orally at 300–600 mg 2–3 times a day, regardless of meals. If the disorder lasts a long time, treatment is continued for several weeks, prescribing Mebicar according to an individual regimen from 1.8 to 10 g per day. As a means of reducing the desire to smoke tobacco (in complex therapy) - 300 - 900 mg per day for 5 - 6 weeks. The maximum single dose of Mebicar is 3 g, the maximum daily dose is up to 10 g. The duration of treatment is from several days to 2-3 months; with mental illness - up to 6 months. Mebicar can be used in combination with antipsychotics and other tranquilizers.

Medications should only be taken as directed by a doctor
(self-medication may harm your health)