Etifoxine, sold under the trade name Stresam among others, is a nonbenzodiazepine anxiolytic agent, primarily indicated for short-term management of adjustment disorder, specifically instances of situational depression accompanied by anxiety, such as stress-induced anxiety. Administration is by mouth. Side effects associated with etifoxine use include slight drowsiness, headache, skin eruptions, and allergic reactions. In rare cases, etifoxine has been linked to severe skin and liver toxicity, as well as menstrual bleeding between periods. Unlike benzodiazepines, etifoxine does not cause sedation or lack of coordination. Etifoxine acts as a ligand for translocator proteins.

Etifoxine was developed in the 1960s and was introduced for medical use in France in 1979. Its marketed in 53 countries worldwide, although it remains unavailable in the United States. Throughout the 2010s and early 2020s, the safety profile of etifoxine was scrutinized within France and the European Union, prompted by reports of toxicity. The investigation revealed that instances of toxicity were infrequent, and etifoxine was allowed to remain on the market.

Etifoxine has historically been used in the treatment of "psychosomatic manifestations of anxiety", for instance "autonomic dystonia, particularly with cardiovascular expression". Subsequently, the indication for etifoxine has been more formalized as treatment of adjustment disorder (situational depression) with anxiety (ADWA) (e.g., stress-related anxiety). Etifoxine has been found to reduce scores on the Hamilton Anxiety Rating Scale (HAM-A) in people with adjustment disorder with anxiety by approximately 50 to 75% after 4 weeks of treatment in clinical trials (e.g., AMETIS, ETILOR, ETIZAL, STRETI studies). The medication is similarly effective or more effective than benzodiazepines like lorazepam, alprazolam, and clonazepam and more effective than buspirone for adjustment disorder with anxiety on the basis of directly comparative randomized controlled trials. However, in the AMETIS study, both etifoxine and lorazepam failed to show greater effectiveness over placebo.

In the trials comparing etifoxine to clonazepam, lorazepam, and alprazolam, total daily doses of the benzodiazepines were limited to their maintenance dose, set at 1 mg, 2 mg, and 1.5 mg, respectively, in t.i.d. Such an inflexible dosing regime limits the utility benzodiazepines offer in practice; e.g. lorazepam and alprazolam can be used as needed for situational anxiety in which continuous use is unnecessary or excessive, while clonazepam can be titrated to response when continuous relief is indicated, up to a maximum of 4 mg a day, four times greater than the dose used in comparison with etifoxine over the 24 week duration of the trial. In general, they offer a degree of personalization that is not possible with etifoxine. Indeed, better evidence is required before etifoxine can be said to replace benzodiazepines in practice, especially considering the trials above were relatively small in size, along with the high attrition rates and lack of personalization of the benzodiazepines used.

The usual dosage of etifoxine (as the hydrochloride salt) is 150 to 200 mg per day in divided doses of 50 to 100 mg two to three times per day (e.g., 50 mg–50 mg–100 mg). It is taken for a few days to a few weeks, but no longer than 12 weeks.

Etifoxine is provided in the form of oral capsules containing 50 mg etifoxine hydrochloride.

Etifoxine is contraindicated in people with circulatory shock, severe liver impairment, severe kidney impairment, myasthenia gravis, galactosemia (due to lactose in the drug formulation), severe respiratory failure, and hypersensitivity (allergy) to etifoxine. The medication is not recommended in children or adolescents under the age of 18 and is not recommended during pregnancy and breastfeeding due to insufficient data. Caution is warranted with regard to combining etifoxine and other central depressants such as benzodiazepines, central analgesics, antipsychotics, sedative antihistamines, and alcohol.

Side effects of etifoxine include slight drowsiness and headache. Rarely, etifoxine can cause benign skin eruptions or rashes and allergic reactions such as hives and angioedema. Etifoxine shows less adverse effects of anterograde amnesia, sedation, impaired psychomotor performance, and withdrawal syndromes than those of benzodiazepines. No cases of misuse or dependence with etifoxine were identified in a French pharmacovigilance survey, which is also in contrast to benzodiazepines.