Meds That Treat Anxiety
Anxiety is among the most common mental health issues, affecting 40 million adults in the United States. There are a variety of medications available to treat anxiety.
SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), like Zoloft, Prozac, Lexapro and Effexor, work to alleviate anxiety by raising levels of the chemical serotonin in the brain. In contrast to benzodiazepines, they're addictive.
SSRIs
The most commonly used anxiety medications are selective serotonin-reuptake inhibitors (SSRIs) which include citalopram (Celexa), escitalopram (Lexapro) and fluoxetine (Prozac). These drugs also treat depression, and they can help relieve the symptoms of anxiety disorders, including obsessive-compulsive disorder (OCD). They can take up to a month before they begin working.
These drugs work by boosting the production of certain chemical messengers in the brain, such as serotonin and norepinephrine. These are typically the first option to treat anxiety, though doctors may prescribe other forms of antidepressants, also known as benzodiazepines.
Antidepressants like duloxetine (Cymbalta), and venlafaxine, (Effexor) are also used to treat anxiety. They operate a bit differently than SSRIs because they reduce the reabsorption of norepinephrine as well as serotonin, though at lower levels than SSRIs. These medications take a lengthy time to be effective and are more expensive than SSRIs.
Tricyclic antidepressants (TCAs), such as imipramine (Tofranil) are effective in treating some anxiety disorders, particularly GAD. Their drowsiness, and other side effects, make them less popular. Another kind of antidepressant, monoamine oxide inhibitors (MAOIs) are also able to be used to combat anxiety. However, how anxiety is treated I Am Psychiatry and the risk of toxicity limit their usage.
Benzodiazepines can be used to combat panic attacks and anxiety in the short-term, while waiting for SSRIs and SNRIs. These medications can trigger addiction, tolerance, and sedation as well as withdrawal symptoms like a rebound anxiety, depression and delirium. Benzodiazepines are commonly found in alprazolam as well as clonazepam and lorazepam.
Therapy is an essential part of any anxiety treatment plan. It assists you to better be aware of your symptoms and root causes. Many people find that both therapy and medication can help them manage their anxiety. Certain studies have demonstrated that cognitive behavioral therapy can be just as effective as medications for anxiety. Talk with your physician about your options and what might be best for you.
Benzodiazepines
Benzodiazepines have a calming effect, decrease anxiety and relax tense muscles. They also ease symptoms of bodily arousal due to fear (like heart rate and trembling) and encourage sleep.
The way they function is by binding to inhibitory neurotransmitters, such as gamma-aminobutryic acid or GABA which is a receptor in the central nervous system. They boost the effects of GABA by facilitating the inhibitory effects of GABA on other neurotransmitters and reducing the number of messages that are sent to the amygdala. This is a region of the brain that is able to detect the threat and triggers a feeling of anxiety.
These medications are sometimes employed for short periods of time, such as during a panic attack or severe anxiety episodes. They may help relieve symptoms within 30 to 90 minutes of taking them. Contrary to SSRIs which are a long-lasting medication, benzodiazepines do not stay in the body for a long time. They're fast-acting and usually work in a matter of hours, making them suitable for situations in which immediate relief is required (like during an airplane flight or before an event in public).
They can be addictive, so people are generally only prescribed them for up to 4 weeks at a time. After that period they cease to be effective.
One of the reasons benzodiazepines became so popular is that they were effective and had a few adverse effects when compared with their predecessors, such as barbiturates or meprobamate. They are effective and have a rapid start, and can be employed as anxiolytics to decrease anxiety. They can also be employed as sedatives, anticonvulsants and muscle relaxants.
Benzos are often blamed for the negative attitudes toward anxiety that developed in the 1970s and 1980s, including the stigmatization of anxiety and the perception that benzodiazepine treatment leads to physical dependence. Despite this however, benzodiazepines still play a major role in the treatment for anxiety disorders, particularly when combined with psychosocial interventions like cognitive behavioral therapy and other interpersonal therapies.
Benzos can interact with other medications and cause undesirable side effects, such as drowsiness and disorientation. It is recommended to inform your doctor about any prescription, nonprescription, or herbal medicines you currently use or are planning to take. Take a look at the British National Formulary A to Z list of interactions with medications to determine which medicines are safe to take with benzodiazepines.
Antidepressants
Antidepressants can be effective in treating anxiety and other mental conditions. According to the Anxiety and Depression Association of America, antidepressants -- like SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs) -- can help reduce chronic anxiety disorder, obsessive-compulsive disorder (OCD), panic disorders and generalized anxiety disorder (GAD). The FDA has approved antidepressants to treat other health conditions, such as bipolar disorder, eating disorders and certain kinds of pain.
SSRIs are often prescribed as a first-line treatment option for anxiety by doctors, but they might not be effective for everyone. If they fail, doctors may try the older type of antidepressant known as tricyclic or tetracyclic an antidepressant. These include amitriptyline and nortriptyline and clomipramine. These antidepressants are less common but they are still readily available. Your doctor may also prescribe the antidepressant with a sedating effect, Trazodone (Desyrel) at lower doses to treat anxiety or insomnia.
Other antidepressants that could help are nefazodone (Ferdinand) and duloxetine (Cymbalta). These drugs are also available in generic form. If they aren't working, your physician can try the antidepressant that is sedating, mirtazapine (Remeron) or the antipsychotics quetiapine or olanzapine.
Medications for other anxiety disorders include beta blockers, which decrease the blood pressure and heart rate by blocking the actions of adrenaline. These drugs aren't commonly used to treat anxiety on their own however they can be helpful when combined with psychological therapy.
Psychotherapy can assist you to change negative thoughts and behavior that cause anxiety. It will help you learn to control your anxiety, and build coping skills. Based on your specific situation, you may undergo cognitive behavioural therapy or exposure therapy. Cognitive behavioural therapy teaches you to confront negative and fearful thoughts and overcome your fear of situations that trigger anxiety. Exposure therapy involves gradually increasing the level of anxiety-inducing situations until are able to handle the stressors. This can be done in a single session or in a small group. In both cases it takes time to show results. Some people find that a combination of medication and psychotherapy is the best option. Some people find that taking medication alone is enough to manage symptoms. Discuss with your doctor how you manage your symptoms.
Other Medicines
Other medications can also aid in relieving your symptoms. Beta blockers, antihistamines and buspirone are all prescribed to ease anxiety.
These medications can help ease your symptoms, by reducing or blocking the signals that cause anxiety and stress. They're not a panacea. You'll have to take steps to control anxiety, like exercises as well as relaxation techniques, and psychotherapy.
The SSRIs or SNRIs are often the first choice of anxiety medications that your doctor might prescribe. According to studies, these medications are the most effective in treating anxiety disorders. The most commonly used SSRIs include sertraline (Zoloft) and the fluoxetine (Prozac), Citropram (Celexa) and escitalopram (Lexapro). These medications might have mild side effects, such as nausea or insomnia, but they typically subside within 4-8 weeks. Unlike the benzodiazepines, they're not addictive and won't increase your risk of having suicidal ideas.
The benzodiazepines alprazolam (Xanax) and clonazepam (Klonopin) and diazepoxide (Valium) provide immediate relief for anxiety and panic attacks however they can also cause negative effects such as dizziness, drowsiness, memory and coordination issues, and dependence. They're a less popular choice over the more traditional barbiturates however, they're equally effective.
Antihistamines such as Vistaril (hydroxyzine) were initially designed to help with allergies. However, they are also used to reduce anxiety symptoms. Hydroxyzine blocks the histamine receptors in the brain and can cause a calming effect. It's not a controlled drug which means it doesn't carry the same risks of addiction like benzodiazepines.
Anticonvulsants are a different kind of medication that can help with anxiety. They have been proven to reduce anxiety through inhibiting the production of and release dopamine and sérotonin. These medications may be prescribed as a part of a combination therapy or used to treat anxiety in the short-term. Your doctor will assess your health history and symptoms to determine if these medicines are suitable for you. They will also discuss the length of time you should take these medications as well as any possible adverse effects that could occur. Anxiety medications are only available on prescription, which means that you'll need a psychiatrist to prescribe it.