Acute anxiety, short-term treatment
Acute anxiety or panic episode requiring short-term relief (up to 2–4 weeks). Benzodiazepines are restricted due to dependence risk.
ICD-10 F41.95 drugs
Also known as: Acute anxiety episode
Drugs used for this condition
- BDiazepamSecond line · Anxiolytics. Benzodiazepine derivativesBenzodiazepines are used for short-term relief of acute anxiety or panic attacks, limited to 2–4 weeks. NICE CG113 and Russian clinical guidelines emphasize avoiding long-term use due to dependence and tolerance risk. First-line drugs for anxiety disorders are SSRIs and SNRIs combined with CBT.
- BPhenazepamSecond line · Anxiolytics. Benzodiazepine derivativesPhenazepam is registered in Russia for acute anxiety and neurotic states. Evidence base is limited to local studies: not referenced in international guidelines, not approved by FDA or EMA, no Cochrane systematic reviews. Treatment course should not exceed 2 weeks due to high dependence potential.
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- FHaloperidolNot recommended · First-generation antipsychotics. Butyrophenone derivativesIn non-psychotic patients haloperidol is not used for anxiety or insomnia. International guidelines (NICE CG113, APA) treat anxiety with SSRIs, SNRIs, CBT; benzodiazepines short-term only. Antipsychotic use for anxiety carries risks of extrapyramidal effects and QT prolongation without proven benefit.
- FPhenobarbitalNot recommended · Antiepileptics. BarbituratesUse of phenobarbital and combination products containing it (Corvalol, Valocordin, Barboval) for anxiety, insomnia, or cardiovascular symptoms is not supported by international guidelines. Barbiturates were displaced by benzodiazepines in the 1970s due to a narrower therapeutic index and high dependence risk. Long-term regular use of Corvalol and similar products leads to physical dependence, withdrawal with seizures and psychosis, and bromide accumulation (bromism). In the EU these combinations are banned or regulated as prescription psychoactive substances.
- FValproic acidNot recommended · Antiepileptics. Fatty acid derivativesUse of valproate in women of reproductive age without strict contraception and without compelling indication is not supported by international regulators. EMA 2018 and MHRA Pregnancy Prevention Programme require annual signed informed consent, mandatory effective contraception, and regular pregnancy testing. Valproate is among the most teratogenic antiepileptics: neural tube defect risk approximately 10%, average IQ reduction of 7–10 points in offspring.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit