Medications for Anxiety
Anxiety affects many people at some point during their lives.
Symptoms of anxiety can include excessive worry or fear along with physical symptoms, such as muscle tension and tiredness.
While anxiety can be a healthy response to uncertainty and threats, constant worry and nervousness may be a sign of what is called generalized anxiety disorder. Generalized anxiety disorder can interfere with daily functioning, including work, school, social activities, and personal relationships. Other types of anxiety disorders, such as panic disorder, social anxiety disorder, and specific phobias, arise from particular situations and can cause distress.
How is anxiety treated?
Health care providers generally treat anxiety disorders with medication, psychotherapy, or a combination of both. The most common types of medications health care providers use to treat anxiety disorders are antidepressants and benzodiazepines. In some cases, you may need to take more than one medication. You should work with your health care provider to receive the treatment for anxiety that works best for you.
Note that your health care provider may prescribe other medications to help manage your symptoms that are not approved by the U.S. Food and Drug Administration (FDA) to treat anxiety. This is called “off-label” use of a medication. Examples of medications used off-label to treat anxiety include beta blockers and anticonvulsants.
Antidepressants used for anxiety
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), may be used as first-line treatments for anxiety. Examples of commonly used SSRIs to treat anxiety include escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). The serotonin-norepinephrine reuptake inhibitors (SNRIs) duloxetine (Cymbalta) and venlafaxine (Effexor) may also be used to treat anxiety.
According to the U.S. National Institute of Mental Health, antidepressants take longer to work than other medications, up to several weeks, but they also may provide greater symptom relief compared to other drugs over time. It is important to take antidepressants long enough to be effective. If you take antidepressants, do not stop taking them without talking to your health care provider first.
Benzodiazepines used for anxiety
Benzodiazepines are sedative medications that are commonly used for anxiety. Benzodiazepines act more quickly than antidepressant medications in relieving anxiety, but you can build up a tolerance to them over time, which means you may need a higher dose for the same effect. For this reason, your health care provider may only prescribe benzodiazepines for a short period of time. Sometimes health care providers prescribe both benzodiazepines and antidepressants together. Benzodiazepines can work to treat symptoms of anxiety during the time before the antidepressants take full effect. Once the antidepressant works, your health care provider may have you taper off the benzodiazepine. Examples of benzodiazepines include alprazolam (Xanax), chlordiazepoxide (Librium), diazepam (Valium), clonazepam (Klonopin) and lorazepam (Ativan).
Other medicines used for anxiety
Buspirone (Buspar), hydroxyzine (Atarax) and meprobamate (Miltown, Equanil) may also be used to manage anxiety.
What medications are used for panic attacks?
Your health care provider may prescribe SSRIs, such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), or the SNRI venlafaxine (Effexor) for the symptoms of panic attacks. However, antidepressants generally take several weeks to start working and do not result in immediate relief of symptoms of panic attacks. Benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin), chlordiazepoxide (Librium), diazepam (Valium), and lorazepam (Ativan), work quickly to decrease panic attack symptoms, but they can cause tolerance and dependence if used long-term, so your health care provider may only prescribe them for a short time.
What medications are used for social anxiety disorder?
The SSRIs sertraline (Zoloft) and paroxetine (Paxil) and the SNRI venlafaxine (Effexor) are often used to treat social anxiety disorders. Other options used for the treatment of social anxiety disorder include benzodiazepines.
What are the side effects of medications used for anxiety?
Like all medicines, medications for anxiety have the potential to cause side effects. Specific side effects may vary, depending on the type of medication. If you experience side effects from your medication, you should speak to your health care provider. Health care providers stress that it is important to not stop taking your medication for anxiety without medical supervision as it may cause withdrawal symptoms. When you and your health care provider have decided it is time to stop a medication for anxiety, they will help you slowly and safely decrease your dose.
SSRIs and SNRIs do not cause as many side effects as older antidepressants, such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs). Side effects of SSRI and SNRI antidepressants may include sexual problems, weight gain, headache, nausea, sleepiness and insomnia (trouble falling or staying asleep). In addition, the FDA requires all antidepressants to carry a warning relating to the risk of suicide in children and young adults. According to the FDA, antidepressant use in children and teens must be monitored carefully because there can be severe side effects in rare cases.
Benzodiazepines can cause drowsiness, dizziness, blurred vision, nausea, headaches, confusion, tiredness, nightmares and physical dependence. People who take benzodiazepines can build up a tolerance to them if they are taken over a long period. Thus, they may need higher doses to get the same effect. Some people may even become dependent on them.
Non-prescription products for anxiety
There are no proven non-prescription nutritional or herbal supplements for the treatment of anxiety. You may wonder if herbs can aid in relieving anxiety symptoms. Herbal remedies can have calming effects, but these are generally mild, and none are approved by the FDA for alleviating the symptoms of anxiety. Some herbal products, such as St. John’s Wort, may interact with medications used to treat depression or other mood disorders. Make sure you tell your pharmacist about all prescription and over-the-counter medications, supplements, herbs, vitamins and minerals you take. They can identify possible drug interactions.
Published on November 12, 2020