Tranquilizers (from Lat. Tranquillo - calm), or anksiolitiki (from Lat. Anxietas - anxiety, fear + gr. Lytikos - capable of dissolving, weakening), or ataraktiki (from Greek. Ataraxia - imperturbability) - psychotropic drugs, which reduce the severity or suppress anxiety, fear, anxiety, emotional tension.
First tranquilizers (gidroksizin, meprobamat) were synthesized in 50-ies of the XX century. Widely used in medical practice, tranquilizers were from 60-ies of XX century. When the first benzodiazepinovye anksiolitiki - hlordiazepoksid and diazepam.
Tranquilizers have a wide range of pharmacological actions. They have not only anxiolytic effect, but also have sedative, hypnotic, miorelaksiruyuschee, anticonvulsant, and amnesticheskoe vegetostabiliziruyuschee operation.
The main effect of tranquilizers is anxiolytic (protivotrevozhny). Anxiolytic effect is manifested in the reduction of anxiety, fear (antifobicheskoe effect), the emotional tension.
Sedative (calming) effect is to reduce psychomotor excitability, daily activity, a decrease of concentration, slow reactions, etc.
Hypnotic (hypnotic) effect manifests itself in facilitating the onset of sleep and an increase in its duration. Depressant effect of tranquilizers on the central nervous system leads to mutual reinforcement of the effects of sleeping-pills, anesthesia and analgetics funds.
Miorelaksiruyuschy effect (relaxing the skeletal muscles) in the application of tranquilizers tended to be a positive factor for the withdrawal of voltage excitation, including motor. However, this effect may limit the use of drugs in patients whose work requires quick mental and physical reactions. It should also be borne in mind that miorelaksiruyuschee operation can take the feeling of drowsiness, weakness, etc.
Anticonvulsant effect is to suppress the proliferation of epileptogennoy activity, resulting in epileptogennyh pockets.
Amnesticheskoe action (ability to cause amnesia) is manifested mainly in the parenteral (injection) application. The mechanism of this effect is not yet clear.
In the spectrum of certain tranquilizers emit vegetostabiliziruyuschy effect (normalization of functional activity of the autonomous nervous system). Clinically, this effect can occur decreases autonomic manifestations of anxiety (tachycardia, hypertension, sweating, a violation of the functions of the digestive system, etc.).
The clinical use of tranquilizers is related mainly to their protivotrevozhnym action. Tranquilizers are used in all types of anxiety disorder, in addition, they can be used to treat anxiety or to short-term symptoms of anxiety.
Although tranquilizers may exercise all the characteristics for this group of pharmacological properties, expression, and the ratio of the effects of different drugs may be different, hence the features of their clinical application.
It should be remembered that the treatment of tranquilizers can be carried out only under medical supervision, since the use of tranquilizers can lead to habituation (reduction in the long admission), as well as to the formation of drug dependence (physical and / or mental) and a syndrome cancel. The risk of dependence increases with prolonged use. Because of the higher risk of dependence use tranquilizers in children and adolescents under the age of 18 is justified only in exceptional cases, a clear evidence-based, with the duration of treatment should be minimal.
In connection with the weakening of concentration and slowing down of psychomotor reactions should appoint tranquilizers outpatient care, particularly for patients whose work requires high concentration and rapid mental and physical reactions (drivers, dispatchers, etc.).
When you receive tranquilizers is not alcohol, because alcohol increases the depressant effects of drugs of this group in the central nervous system that may be accompanied by a danger to the life of heavy side effects, including loss of consciousness and respiratory depression.
In the appointment of tranquilizers for the treatment of anxiety disorder should observe the principle of gradual dose increase - from minimally effective for up to an optimal therapeutic effect (apart from a severe condition). The treatment should be as short as possible, and then must re-evaluation of the patient to decide on the need for continued therapy.
In connection with the possibility of development of drug dependence and addictive Conciliation Commission, WHO (1996) is not recommended to use tranquilizers benzodiazepinovogo number continuously for more than 2-3 weeks. If you need long-term treatment (several months) course is recommended that the discontinuous method, discontinue receiving the drug for several days, followed by the appointment of the same individually tailored doses. To reduce the risk of developing the syndrome lifting, with the lifting of the drug dose is recommended to decrease gradually.
