Meds That Treat Anxiety
Anxiety affects 40 million adults in the United States. It's highly 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. Unlike benzodiazepines, they're not addictive.
SSRIs
The most commonly used anxiety medication is selective serotonin inhibits (SSRIs), including citalopram, escitalopram, and fluoxetine. These drugs can also be used to treat depression as well as relieve symptoms of other anxiety disorders such as obsessive compulsive disorder. It can take up to one month for them to start working.
These drugs increase the levels of certain chemical messengers within the brain, including serotonin and norepinephrine. These medications are typically the first option to treat anxiety, though doctors may prescribe other forms of antidepressants or benzodiazepines.
Antidepressants such as duloxetine, (Cymbalta) and venlafaxine (Effexor) are also used for anxiety. They operate a bit differently from SSRIs because they reduce the reabsorption of norepinephrine as well as serotonin, though at lower levels than SSRIs. These medicines can take a while to take effects, and they tend to be more expensive than SSRIs.
Tricyclic antidepressants like imipramine Tofranil can be effective for treating anxiety disorders. Their drowsiness, as well as other side effects, make them less popular. Another form of antidepressant is monoamine oxidase inhibitors (MAOIs), can also be used to treat anxiety. However, anxiety treatment at home and the risk of toxicity restrict their use.
Benzodiazepines are frequently used to treat anxiety and panic attacks in the short-term like when you wait for SSRIs or SNRIs to take effect. These medications can trigger dependence to tolerance, sedation, and dependence as well as withdrawal symptoms such as a rebound anxiety, depression and delirium. Benzodiazepines can be found in alprazolam as well as clonazepam and lorazepam.
Therapy is a vital part of any treatment plan for anxiety. It assists you to better understand your symptoms and their causes. Many people find that therapy and medication help them to cope. Certain studies have proven that cognitive behavioral therapy is as effective as medication for anxiety. Speak to your doctor to determine what is the best option for you.
Benzodiazepines
Benzodiazepines have an calming effect, reduce anxiety and relax tense muscles. They also alleviate symptoms of bodily arousal due to fear (like heart racing and trembling) and encourage sleep.
They function by binding to inhibitory neurons, like GABA or gamma aminobutryic acid, at receptors within the central nervous system. They boost the effects of GABA by facilitating the inhibitory effect of GABA on other neurotransmitters, and reducing the number of messages that are sent to the amygdala. This is a part of the brain that evaluates threats and creates a sense of anxiety.
These medications can be utilized for short durations of time for instance, when a panic attack occurs or if you're experiencing extreme anxiety. They may ease the symptoms within 30 to 90 minutes of taking them. Contrary to SSRIs, benzodiazepines don't remain in the body for long. They are fast acting and can be used within a couple of hours. This makes them ideal for situations in which quick relief is required (such for instance, during an airplane ride or before a presentation in public).
As they can be addictive, people are typically prescribed for a period of up to four weeks at a go. After that time they cease to be effective.
One of the main reasons benzodiazepines were so popular was that they were effective and had few side effects when compared to their predecessors, such as barbiturates or meprobamate. They have a rapid time to begin their action and are extremely effective as anxiolytics (anti-anxiety), sedatives, anticonvulsants, as well as for muscle relaxants.
Benzos were blamed for the negative attitudes towards anxiety that emerged in the 1970s and 80s, including the minimization of the disorder, and the perception that benzodiazepine therapies can lead to physical dependence. Yet however, benzodiazepines still play a significant role in the treatment for anxiety disorders, especially when combined with psychosocial interventions, such as cognitive behavioral therapy or interpersonal therapies.
Benzos can interact with other medications and trigger unwanted side effects, such as drowsiness or confusion. It's important to let your doctor be aware of any other prescription, non-prescription or herbal medications you are contemplating or are taking. Go through the British National Formulary A to Z list of medication interactions to find out which medications are safe when taken 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 eating disorders, bipolar disorder and certain types of pain.
Most doctors recommend SSRIs as the first-line treatment for anxiety, however these drugs may not be effective for everyone. If these antidepressants aren't working the doctor might suggest an older type called a tetracyclic or tricyclic antidepressant. These include amitriptyline and nortriptyline and Clomipramine. These antidepressants aren't as common but they are still available. You can also ask your physician to prescribe the sedating antidepressant, trazodone(Desyrel) at lower doses if you're experiencing sleep issues or anxiety.
Other antidepressants that may aid are the nefazodone (Ferdinand) and duloxetine (Cymbalta). They're also available in generic form. If they don't work your doctor, you can try the antipsychotics quetiapine and olanzapine or the sedative antidepressant Mirtazapine.
Beta blockers are used to treat other anxiety disorders. They lower blood pressure and heart rate by blocking adrenaline. These medications aren't typically used for anxiety alone however they can be helpful when combined with psychological therapy.
Psychological therapy can help you overcome negative thoughts and behaviors that cause anxiety. It will help you learn to control your anxiety, and develop coping skills. Depending on the severity of your problem, exposure therapy or cognitive behavior therapy could be suggested. Cognitive behavioural therapy teaches you to confront unhelpful and fearful thoughts, and to overcome your aversion to situations that cause anxiety. Exposure therapy involves increasing the intensity of anxiety-inducing situations until they are manageable. It can be carried out either in a group, or by yourself. In both cases, it takes time to achieve results. Some people find that a combination of medication and psychotherapy is the best option. Some people find that medication alone is sufficient to treat symptoms. Discuss with your doctor how you manage your symptoms.
Other Medications
Other drugs can also help alleviate your symptoms. Antihistamines and beta blockers are sometimes prescribed to relieve anxiety.
These drugs can help you ease your symptoms, by reducing or blocking the signals that trigger anxiety and stress. They're not a cure-all. You'll need to continue doing other things to manage your anxiety, including exercises, relaxation techniques, and psychological therapy.
Your doctor could initially prescribe one of the "first first" anxiety medications, which include SSRIs and SNRIs. According to studies, these medications are the most effective for treating anxiety disorders. SSRIs are commonly found in sertraline (Zoloft) as well as the fluoxetine, citalopram and escitalopram. These drugs may cause mild side effects, like insomnia or nausea, but they typically subside within 4-8 weeks. Unlike the benzodiazepines, they're not addictive and don't increase your risk for suicidal thoughts.
The benzodiazepines, such as alprazolam, diazepoxide and clonazepam (Valium) offer immediate relief from anxiety and panic attacks. However, they may cause adverse effects, including dizziness and drowsiness. They may also cause memory and coordination issues, and even dependence. These drugs are less popular than the older barbiturates, but they are equally effective.
Antihistamines like Vistaril (hydroxyzine) were designed to help with allergies however, they're also used to ease anxiety symptoms. Hydroxyzine has a calming effect by blocking the histamine receptors. It's not a controlled substance which means it doesn't carry the same risks of addiction as benzodiazepines.
Another kind of medication that can help with anxiety is a group of medications called anticonvulsants, which have been proven to reduce anxiety by interfering with the production and release of serotonin and dopamine. These medications can be prescribed as part of a combination therapy or to treat anxiety in the short term. Your doctor will assess your symptoms and health history 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 negative side effects. Anxiety medications are only available on prescription, and a psychiatrist will be required to prescribe it.