Anxiolytics and hypnotics treat anxiety, insomnia and seizures. Benzodiazepines (diazepam — also used IV in status epilepticus; lorazepam — used in anxiety and status epilepticus; clonazepam — broad-spectrum anticonvulsant; alprazolam — anxiolytic for panic disorder) enhance GABAergic transmission by binding to the alpha subunit of the GABA-A receptor, increasing chloride channel opening frequency — producing anxiolytic, sedative, hypnotic, muscle relaxant and anticonvulsant effects. Dependence and tolerance risk limits chronic use (maximum 2-4 weeks). Z-drugs (zolpidem) are selective GABA-Aω1 receptor agonists — faster onset, short half-life, indicated for sleep-onset insomnia. Should be avoided in the elderly (falls and fractures risk). (Sources: DailyMed/FDA, EMC-UK/MHRA, BNF)
