From the Guidelines
Short-acting anxiolytic medications, such as benzodiazepines, are commonly prescribed for acute anxiety symptoms, with lorazepam (Ativan), oxazepam (Serax), temazepam (Restoril), zolpidem (Ambien), and triazolam (Halcion) being frequently used options, as noted in the study 1. These medications work by enhancing the effect of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity, thereby reducing anxiety symptoms quickly. Some key points to consider when prescribing these medications include:
- They should generally be used for short periods (2-4 weeks maximum) due to risks of dependence, tolerance, and withdrawal symptoms, as highlighted in the study 2.
- Side effects may include drowsiness, dizziness, and impaired coordination, so patients should avoid driving or operating machinery until they know how the medication affects them.
- For longer-term anxiety management, non-benzodiazepine options like SSRIs or therapy are preferred, as they don't carry the same risks of dependence while providing sustainable anxiety relief, as discussed in the study 3. It's also important to note that long-acting benzodiazepines are discouraged because they can cause psycho-motor impairment during the postoperative period, which can impair mobilisation and direct participation, as mentioned in the study 4. In terms of specific medications, lorazepam is usually prescribed at 0.5-1mg doses taken 2-3 times daily, with effects lasting 6-8 hours, while oxazepam and temazepam have similar effects, as noted in the study 1. Overall, when prescribing short-acting anxiolytic medications, it's essential to weigh the benefits and risks and consider the individual patient's needs and circumstances, as emphasized in the study 5.
From the FDA Drug Label
INDICATIONS Diazepam is indicated for the management of anxiety disorders or for the short- term relief of the symptoms of anxiety. INDICATIONS AND USAGE Buspirone hydrochloride tablets are indicated for the management of anxiety disorder or the short-term relief of the symptoms of anxiety. Lorazepam Oral Concentrate is a prescription medicine used: to treat anxiety disorders for the short-term relief of the symptoms of anxiety or anxiety that can happen with symptoms of depression
The short-acting anxiolytic (anxiety) medications are:
- Diazepam 6
- Lorazepam 7 Note that Buspirone 8 is an anxiolytic, but it is not typically considered short-acting.
From the Research
Short-Acting Anxiolytic Medications
- The following benzodiazepines are considered short-acting anxiolytic medications: + Triazolam 9 + Oxazepam 10 + Lorazepam 10
- These medications are often used for acute stress reactions, episodic anxiety, and fluctuations in generalized anxiety 9, 10
- Short-acting benzodiazepines are preferred for patients with severe symptomatic distress and/or impairment of ability to cope, and for elderly patients or those with hepatic disease or hypoalbuminemia 10, 11
- Alprazolam is also used for short-term treatment of panic disorders, although it carries a risk of withdrawal reactions 12
Characteristics of Short-Acting Anxiolytic Medications
- Short-acting benzodiazepines have a rapid onset of action and are effective in reducing anxiety symptoms 9, 10
- However, they can also produce tolerance, dependence, and withdrawal syndromes, especially with long-term use 9, 11
- It is recommended to use small amounts of these medications for the shortest possible period to minimize the risk of adverse effects 11