How Safe Are Tranquilizers?

The term "tranquilizer" is a somewhat misleading one. The word is typically used in popular culture to describe sedatives, or substances used to induce sedation. The term "tranquilizer" is used less commonly today as it suggests that the drugs induce tranquility, a somewhat vague and inaccurate description of how they work.

It was only in 1953 that the term "tranquilizer" was coined to describe the effects the drug resperine appeared to have on animals.

Today, we would more accurately classify resperine as an anti-hypertensive since its aim is to reduce high blood pressure rather than to induce a tranquil state. These days, when doctors used the word tranquilizer," they do so to classify the drugs into one of two groups:

• Minor tranquilizers are typically anxiolytic drugs used to reduce anxiety.
• Major tranquilizers are typically antipsychotic drugs used to treat psychotic features of schizophrenia, bipolar disorder, and other mood disorders.

Understanding Minor Tranquilizers

When people refer to tranquilizer, they usually mean it to suggest that the drugs can calm nerves, alleviate symptoms of stress, or assist with sleep. These types of drugs are broadly classified as anxiolytics. The medications can be further broken down into five classes of drug:

• Benzodiazepines are prescribed to treat anxiety, insomnia, seizures, muscles spasms, agitation, alcohol withdrawal, and panic attacks. There are no less than 15 benzodiazepines approved for use in the U.S., include Ativan (lorazepam), Valium (diazepam), Klonopin (clonazepam), and Xanax (alprazolam).

• Barbiturates were once widely prescribed to treat insomnia and anxiety. They are seldom used today due to the high risk of abuse and addiction. Barbiturates work by generally sedating the individual rather than suppressing specific pathways of the brain. While they have been largely replaced by benzodiazepines, barbiturates are sometimes used as an anticonvulsant (to treat seizures) or as a general anesthetic.

• Antidepressants are able to treat anxiety by regulating a chemical in the body known as serotonin, considered a natural mood stabilizer. While it may seem counterintuitive to treat anxiety with an antidepressant, both mood states can often co-exist at the same time.
• Sympatholytics are anti-hypertensive drugs that work on the body’s sympathetic nervous system (essentially the "fight-or-flight" response). This class of drug is effective in treating severe anxiety disorders such as post-traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD).
• Opioids are highly addictive drugs which act on the brain’s receptor to reduce the number of pain signals it receives. While they are predominantly used to treat severe pain and induce anesthesia, they are sometimes used to treat cases of severe depression and obsessive-compulsive disorder (OCD).

Informed Use of Minor Tranquilizers

When used appropriately and under the supervision of a qualified physician, minor tranquilizers can be both effective and beneficial. While it may seem reasonable to assume that some of these drugs are "safer" than others, they all have the potential to cause dependence and addition if misused.

In fact, because drugs like Xanax or Valium is so commonly prescribed, people will underestimate their potential for addiction compared to more "dangerous" drugs like Oxycontin (oxycodone) or Vicodin (hydrocodone).

Minor tranquilizers can be useful if taken for a short time. Overuse may not only lead to addiction, it can cause side effects that lead to a worsening of symptoms, including:

• Memory loss
• Paranoia
• Suicidal thoughts
• Aggression
• Agitation
• Confusion
• Slurred speech
• Lack of coordination
• Dizziness
• Headaches
• Grogginess
• Confusion
• Depression
• Fatigue

While some of the more obvious effects (like unsteadiness and slurring) may subside over time, they generally do so in line with an increasing drug dependence.

If you or a loved one is experiencing symptoms of addiction, speak with your doctor about treatment options. Going "cold turkey" is usually not a good idea given the potential for withdrawal symptoms, sometimes severe.

Some health insurance plans today provide partial or full coverage of addiction treatment given the steep rise in opioid addictions the U.S.

Sources:

Health and Human Services. "Sedatives and Tranquilizers." Mass.gov. Boston, Massachusetts; updated 2017.

Weaver, F. "Prescription Sedative Misuse, and Abuse." Yale J Biol Med. 2015 Sep; 88(3): 247-256.