The consumption of anxiolytics has skyrocketed practically throughout the world, but Spain has a sad record: it is the country that consumes the most, according to the latest report from the International Narcotics Control Board. Benzodiazepines break records: 110 daily doses are consumed per 1,000 inhabitants, which means that 11% of Spaniards consume these medications for anxiety or insomnia on a daily basis.
Belgium and Portugal are the other two major consumers of benzodiazepines while Italy, India, Switzerland, China and the United States are the main manufacturers of these anxiolytics.
Most people turn to them to solve their difficulties sleeping, but many also do so to deal with work, economic or health problems, to deal with traumatic life situations and even to digest family conflicts. Obviously, the consumption of drugs for anxiety should be the last solution and always under the prescription of a psychiatrist, accompanied by psychological treatment to address the causes of anxiety or insomnia.
In any case, it is convenient to understand if there are differences between tranquilizers and anxiolytics or muscle relaxants.
Tranquilizers and anxiolytics: what are they and how do they work?
Anxiolytics are also known as “minor tranquilizers” and are prescribed to treat and prevent anxiety symptoms or to control various anxiety disorders. In fact, tranquilizers and anxiolytics are the same, although the term “tranquilizer” is not used as much anymore and it is preferred to classify it with the more clinical term “anxiolytics.”
Benzodiazepines are the most prescribed anxiolytics. Millions are consumed every year in the world, since among them are diazepam (Valium), chlordiazepoxide, flurazepam, clonazepam, midazolam and alprazolam (Xanax).
Anxiolytics act in different ways, depending on their active principle, but in a general sense they calm nervous hyperexcitability and decrease activity without actually producing sedation or sleep, as occurs with hypnotics. However, hypnotics in smaller doses can also act as sedatives, so it’s not unusual for them to be used as anxiolytics, especially for people who also have problems with insomnia.
One of the main side effects of anxiolytics is that they generate addiction, especially if they are consumed for long periods of time or in high doses. The longer you take anxiolytics, the more tolerant you become to the dose, which means that you will need higher doses to have the same effect, which can end up being dangerous for your health.
Likewise, they should not be withdrawn abruptly as it can cause abstinence symptoms, such as confusion, restlessness, insomnia and even seizures. For this reason, a psychiatrist must indicate a guideline to withdraw anxiolytics safely.
Anxiolytic and muscle relaxant: how are they different?
Some people confuse anxiolytics with a muscle relaxant since the perceived effects may be similar, although their mechanism of action is different. Skeletal muscle relaxants are drugs that act on nerve centers to depress skeletal muscle activity, decreasing tone and involuntary movements.
Although there are specific muscle relaxants, such as baclofen, diazepam can also be used, for example, a benzodiazepine that not only relieves anxiety and agitation, but also reduces the polysynaptic reflex, producing muscle relaxation and sedation, as well as having a antispastic. Meprobamate is another anxiolytic that is not only prescribed to treat anxiety but especially tension and associated muscle spasms.
We must not forget that anxiety and muscle tension go hand in hand. Since some muscle relaxants produce CNS inhibition, many of the spasmolytic agents also produce sedation and drowsiness as side effects. Some people experience a feeling of lethargy or even some mental confusion. Many of the muscle relaxants can also cause addiction and abstinence symptoms.
In general, the consumption of muscle relaxants and anxiolytics or tranquilizers should be prescribed by a doctor or psychiatrist, who will evaluate the cause of anxiety or muscle tension to find the most appropriate medication.
Ray, S. D. & Holstege, C. P. (2014) Anxiolytic. Encyclopedia of Toxicology (Third Edition): 280-286.
Aragón, S. M. et. Al. (2008) Relajantes musculares. Revisión. Farmacia Profesional; 22(8): 38-43.
(2021) Informe de la Junta Internacional de Fiscalización de Estupefacientes correspondiente a 2021. In: INCB.