Meds That Treat Anxiety
Anxiety affects 40 million people in the United States. It's extremely treatable with various types of medication available.
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. They aren't addictive, unlike benzodiazepines.
SSRIs
The most popular anxiety medication is selective serotonin inhibits (SSRIs), including citalopram, escitalopram, and fluoxetine. These medications are also used to treat depression as well as relieve symptoms of anxiety disorders, such as obsessive compulsive disorder. It can take up to one month for them to start working.
These drugs increase the amount of certain chemical messengers within the brain, such as serotonin and norepinephrine. They are usually the first option for anxiety, however doctors also employ other kinds of antidepressants as well as benzodiazepines.
Another class of antidepressants called serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta) and venlafaxine (Effexor), are also used to treat anxiety. They are a bit different from SSRIs because they decrease norepinephrine, however at a lower level than SSRIs. They may take some time to take effect, and they also are more expensive than SSRIs.
Tricyclic antidepressants (TCAs) like imipramine (Tofranil) are effective in treating some anxiety disorders, including GAD. Their drowsiness, and other adverse effects, make them less popular. Monoamine oxidase inhibitors (MAOIs) are another type of antidepressant used to combat anxiety. However, their dietary restrictions and the risk of toxicity limit their use.
Benzodiazepines can be used treat panic attacks and anxiety in the short-term in the meantime, while waiting for SSRIs and SNRIs. These drugs can trigger tolerance addiction, sedation as well as withdrawal reactions that include rebound depression, anxiety, and even delirium. Benzodiazepines can be found in alprazolam, clonazepam, and lorazepam.
Therapy is an essential component of an anxiety treatment plan as it can help you understand your symptoms and the reasons. Many people find that both therapy and medication help them cope with anxiety. Some studies suggest that cognitive behavioral therapy is just as effective as medications for anxiety. Talk to your doctor about your options and determine what could be the best choice for you.
Benzodiazepines
Benzodiazepines create an calming effect, reduce anxiety and relax tense muscles. They also relieve symptoms of bodily stress related to fear (like heart racing or trembling), and promote sleep.
The way they work is by binding to inhibitory neurotransmitters like gamma-aminobutryic acids or GABA, at receptors in the central nervous system. They increase the effects of GABA by facilitating the inhibitory effects of GABA on other neurotransmitters, and decreasing the amount of messages sent to the amygdala. This is a region of the brain which assesses the threat and triggers a feeling of anxiety.
These drugs can be used for short periods of time, such as when panic attacks occur or if you are experiencing severe anxiety. They may help relieve symptoms within 30 to 90 minutes after taking them. Contrary to SSRIs, benzodiazepines don't remain in the body for long. They're quick-acting and can be effective within a couple of hours. This makes them suitable for situations where immediate relief is needed (such for instance, during an airplane ride or before a presentation in public).
They are addictive, and it is recommended to only prescribe them for up to four weeks at one time. They also lose effectiveness after that time.
One of the main reasons the benzodiazepines became so well-known is that they were effective and had a few adverse effects when compared to their predecessors, like barbiturates or meprobamate. They are effective and have a rapid onset, and can be used as anxiolytics in order to reduce anxiety. They can also be used as sedatives, anticonvulsants, and muscle relaxants.
Benzos are often blamed for the negative perceptions of anxiety that developed in the 1970s and 1980s, which included the denial of the disorder and the perception that benzodiazepine treatment causes physical dependence. However, they continue to play a significant role in the treatment of anxiety disorders, especially when used in combination with psychosocial interventions, such as cognitive behavioral therapy and interpersonal therapy.
Benzos can interact with other medications and cause unwanted side-effects, such as drowsiness or confusion. It is recommended to inform your doctor about any prescription, nonprescription, or herbal medication you currently take or plan to take. You can determine which medications are safe to take with benzodiazepines through the British National Formulary A-Z list for medication interactions.
Antidepressants
Antidepressants can reduce anxiety and other mental health problems. 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 eating disorders, bipolar disorder and certain types of pain.
Most doctors prescribe SSRIs as a first-line treatment for anxiety, however these medications may not be appropriate for all people. If they fail, doctors may try the older type of antidepressant, known as a tricyclic or tetracyclic antidepressant. These include amitriptyline, nortriptyline, clomipramine and trimipramine, dothiepin, doxepin or imipramine. They're less common than newer antidepressants but are still available. Your doctor can also prescribe the antidepressant that sedates, trazodone (Desyrel) in lower doses to treat anxiety or insomnia.
Other antidepressants that may help are the nefazodone (Ferdinand) and duloxetine (Cymbalta). They're also available in generic forms. If they don't help your doctor, you can try the antipsychotics quetiapine and olanzapine or the sedating antidepressant Mirtazapine.
Treatments for other anxiety disorders include beta blockers, which reduce the blood pressure and heart rate by blocking the action of adrenaline. These drugs are not usually used to treat anxiety alone however they can be effective if used in conjunction with psychotherapy.
Psychotherapy can help you to change negative thoughts and behavior that contribute towards your anxiety. It can teach you to manage your anxiety and develop strategies for coping. Based on the severity of your condition exposure therapy or cognitive behavioral therapy might be recommended. Cognitive behavioural therapy can help you learn to challenge unhelpful thoughts, fearful thoughts and to overcome avoidance of situations that trigger your anxiety. Exposure therapy involves gradually increasing the level of anxiety-inducing situations until you can cope with the stressors. It can be performed in a group or on your own. In both instances, results will take time to manifest. A combination of medication and psychotherapy therapy is the best option for some individuals. Some people find that taking medication alone is enough to manage symptoms. Tell your doctor how you manage your symptoms.
Other Medications
While benzodiazepines and antidepressants are the most frequently prescribed treatment for anxiety, other medications can help ease your symptoms too. Antihistamines, beta blockers, and buspirone are all sometimes prescribed to ease anxiety.
These medications can help ease your symptoms, by reducing or blocking signals that trigger stress and fear. They are not a panacea. You'll still have to take steps to manage anxiety, such as exercises as well as relaxation techniques, and psychological therapy.
Your doctor could initially prescribe one of the "first choices" anxiety medications, which include SSRIs and SNRIs. According to studies, these medications are the most effective for treating anxiety disorders. The most commonly used SSRIs include sertraline (Zoloft) and fluoxetine (Prozac), citalopram (Celexa), and escitalopram (Lexapro). These drugs can cause mild side effects such as insomnia and nausea, however these usually subside in 4-8 weeks. They are not addictive, and they do not increase the risk of suicidal thoughts.
The benzodiazepines alprazolam (Xanax), clonazepam (Klonopin) and diazepoxide (Valium) offer immediate relief for anxiety and panic attacks, but they can have negative effects such as dizziness, drowsiness, memory and coordination issues, and dependence. They're a less popular choice than the older barbiturates, but they're just as efficient.
Antihistamines like Vistaril (hydroxyzine) were originally developed to relieve allergies. However, they are also used to alleviate anxiety symptoms. Hydroxyzine has a calming effect because it blocks histamine receptors. It's not a controlled drug and therefore doesn't carry the same dangers of addiction as benzodiazepines.
Anticonvulsants are a different type of medication which can be used to treat anxiety. I Am Psychiatry have been shown to decrease anxiety by inhibiting the production of and release of dopamine as well as sérotonin. These medications may be used as part of a combination therapy or to treat anxiety in the short-term. Your doctor will examine your medical history and symptoms to determine if these medications are appropriate for you. They'll also discuss the length of time you should take them for and any possible side effects. Anxiety medication is only available on prescription, which means that it is necessary to see a psychiatrist to prescribe it.