Clinical pharmacology of non-benzodiazepine anxiolytics

Non-benzodiazepine anxiolytics can be conveniently divided into those which are not primarily used as anxiolytics, those which pharmacologically but not chemically resemble benzodiazepines, and those which are novel both chemically and pharmacologically. The former include antidepressants, antipsychotic drugs, antihistamines and beta-adrenergic antagonists. The second group comprises a variety of compounds which act on the benzodiazepine/GABA complex and include alpidem and zuriclone. The most important of the non-benzodiazepine anxiolytics is buspirone, which seems to act on 5-HT mechanisms. The field of anxiolytic therapy is changing rapidly. New drugs are being introduced and the use of old ones questioned. It is hoped that drugs will be developed which are not only effective and safe with no sedation, but also with little or no propensity to dependence and abuse.