What Is the Difference Between Sedatives and Anxiolytics?-HealthQM

What Is the Difference Between Sedatives and Anxiolytics?

Sedatives are drugs that reduce excitation and irritability, while anxiolytics are drugs that treat anxiety disorders such as social disorder or panic disorder. However, excitation and irritability are symptoms of anxiety disorders, and therefore, both are used for the treatment of anxiety disorders.

1. What Is Excitability and Irritability?

Excitation is a physiologic transition from a state of rest to a state of brain activity caused by stimuli, while irritability is the ability to respond to stimuli with an excessive sensitivity after excitability.

Irritability is also one of the symptoms of anxiety but also a symptom associated with several psychological and neurological disorders.

2. What Are Anxiety Disorders?

Anxiety disorders are the most prevalent psychiatric disorders characterized by uncontrollable worries and fear associated with emotions, thoughts, ideas, and places.

Anxiety disorders can significantly affect the daily life of an individual and commonly manifest with symptoms, including irritability, focusing difficulties, chest pain, increased heart rate, and abdominal discomfort [1].

2.1. What Are the Types of Anxiety Disorders?

There are several types of anxiety disorders, including:

  • Panic Disorder
  • Agoraphobia
  • Generalized Anxiety Disorder
  • Social Anxiety Disorder (Social Phobia)
  • Specific Phobia
  • Separation Anxiety Disorder
  • Selective Mutism
  • Mixed Anxiety and Depressive Disorder

2.1.1. Panic Disorder

A panic disorder is characterized by sudden and repeated episodes of intense fear attacks that physically manifest with the following symptoms:


  • Tremor
  • Chest pain
  • Sweating
  • Palpitations
  • Feeling of choking
  • Abdominal discomfort
  • Paraesthesia (Abnormal sensations of the skin)
  • Feeling of unreality

2.1.2. What Is Agoraphobia?

Agoraphobia is the fear of being unsafe in places such as closed spaces, public transports, crowds, elevators, or being outside of the home, and which results in panic attacks.

2.1.3. What Is Generalized Anxiety Disorder?

Generalized anxiety disorder is characterized by excessive and unrealistic worries about events and activities. It manifests with the following symptoms:

2.1.4. What Is Social Anxiety Disorder?

Social anxiety disorder or social phobia is characterized by a fear of being the center of attention in situations where we might be negatively evaluated, such as public speaking, job evaluation by line managers, or discussion with persons from the opposite sex.

2.1.5. What Is Specific Phobia?

Specific phobia is characterized by an overwhelming fear of a specific situation (e.g., Airplanes), animal (e.g., Spider), or natural phenomena (e.g., Heights).

2.1.6. What is Separation Anxiety Disorder?

Separation anxiety disorder is an overwhelming fear of being separated from places or individuals to whom we are attached. This anxiety disorder is only diagnosed in children.

2.1.7. What Is Selective Mutism?

Selective mutism is characterized by the fear to speak in situations in which the individual is expected to speak while being able to speak in other situations.

2.1.8. What Is Mixed Anxiety and Depressive Disorder?

Mixed anxiety and depressive disorder is characterized by the presence of a balanced mix of anxiety and depression symptoms which makes a diagnosis of either anxiety disorder or depression difficult.

2.2. How Are Anxiety Disorders Treated?

Treatment of anxiety disorders involves lifestyle changes, psychotherapy, and pharmacotherapy (medications).

Lifestyle changes involve:

  • Tacking a time out to clear your head
  • Limiting alcohol and caffeine consumption
  • Getting enough sleep
  • Consumption of well-balanced meals
  • Exercising to maintain health and reduce stress
  • Maintaining a positive attitude
  • Learn about your anxiety disorder and what triggers it.

Psychotherapy involves cognitive behavioral therapy which involves changing and challenging distorted behaviors, thoughts, beliefs, and attitudes, to reduce the symptoms of anxiety disorders.

However, if the symptoms of the anxiety disorder are severe such as suicidal thoughts, alcohol abuse, or secondary depression, anxiolytics are used to alleviate the symptoms.

3. What Are Sedatives and Anxiolytics?

Sedatives and anxiolytics are used to alleviate symptoms of anxiety, treat insomnia, and reduce excitation and irritability to restore calmness.

They grouped into the following categories:

  • Barbiturates
  • Benzodiazepines
  • Selective Serotonin Reuptake Inhibitors
  • Miscellaneous Sedatives and anxiolytics

3.1. What Are Barbiturates?

Barbiturates are used for the treatment of anxiety, insomnia, and epileptic seizures. They exert their effects by enhancing the activity of GABA.

GABA (Gamma-Aminobutyric acid) is a chemical messenger and the major inhibitor of neurotransmission by reducing nerve impulses (action potential).

They also bind to AMPA receptors which prevent the binding of glutamate and block the excitation of neurons.

Barbiturates include drugs such as primidone (Mysoline), phenobarbital (Luminal, Mebaral), butabarbital (Butisol), and pentobarbital (Nembutal).

3.2. What Are Benzodiazepines?

Benzodiazepines prevent the excitation of neurons by enhancing the effect of GABA on GABAA receptors.

GABA (Gamma-Aminobutyric acid) is a chemical messenger and the major inhibitor of neurotransmission by reducing nerve impulses (action potential).

Therefore, it has an opposite action to that of glutamate and ensures balanced neurotransmission [2].

Benzodiazepines are used for the treatment of anxiety, panic disorder, sleep disorders (e.g., insomnia), epileptic seizures, as a muscle relaxant, and for the treatment of alcohol withdrawal.

Benzodiazepines include drugs such as diazepam (Valium), midazolam (Versed), clonazepam (Klonopin), clobazam (Onfi), lorazepam (Ativan), temazepam (Restoril), flurazepam (Dalmane), oxazepam (Serax), and clorazepate (Tranxene T-Tab).

3.3. What Are Selective Serotonin Reuptake Inhibitors (SSRIs)?

Selective serotonin reuptake inhibitors (SSRIs) increase extracellular neuronal concentrations of serotonin by inhibiting its reuptake by monoamine transporters; however, this high concentration results later in the downregulation of serotonin receptors, and therefore, serotonin activity.

Serotonin is a chemical messenger involved in the neurotransmission of information related to mood, reward, learning, memory, and cognition.

Selective serotonin reuptake inhibitors (SSRIs) are primarily used as antidepressants for the treatment of major depression but also for anxiety disorders.

SSRIs include drugs such as citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), escitalopram (Lexapro), and sertraline (Zoloft).

3.3. What Are Miscellaneous Sedatives and Anxiolytics?

Miscellaneous sedatives and anxiolytics are drugs that cannot be classified into the above categories due to their different mechanisms of action.

They are used in the treatment of anxiety, insomnia, alcohol withdrawal, opiates, or barbiturates withdrawal, and for post-operative pain.

Miscellaneous sedatives and anxiolytics include drugs such as buspirone (Buspar), diphenhydramine (Tranquil), doxylamine (Unisom), sodium oxybate (Xyrem), zolpidem (Ambien), melatonin, and ramelteon (Rozerem).


Excitation and irritability are symptoms of anxiety disorders and medications that treat them are also used for the treatment of anxiety disorders.

However, sedatives and anxiolytics are mainly used for severe anxiety disorders, while mild and moderate symptoms are treated through lifestyle changes and cognitive behavioral therapy.

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