Anxiety Medications Used for Bipolar Disorder

Anxiolytics and other medications used for bipolar disorder

Anxiety Medication
What anxiety medications are used for people with bipolar disorder?. OJO Images/Martin Barraud/Getty Images

Anxiety is common with bipolar disorder. What medications and other treatments are commonly used to treat these symptoms?

Anxiety in People with Bipolar Disorder

Research has found that anxiety is common in people with bipolar disorder, with more than half of people experiencing one or more anxiety disorders. Other people may not have enough anxiety symptoms to be formally diagnosed with an anxiety disorder but still need medication to manage their symptoms.

Anxiousness, worry, agitation and insomnia, for example, are often experienced during bipolar depression and mixed episodes. Anxiety symptoms such as restlessness, worry and irritability may occur during mania and hypomania. Thus, it's common for bipolar people to have anti-anxiety medications prescribed.

Anxiety Medications

Anxiety medications, also called anti-anxiety medications or anxiolytics, are prescribed for anxiety disorders as well as for people who have anxiety along with bipolar disorder or major depression. Anxiety medications help to make people less anxious and also help to ease restlessness and worrying. Many of these medications also help people to sleep better. Let's take a look at the different categories of medications which are used to treat anxiety and how they may be used for people with bipolar disorder.

Benzodiazepines for Anxiety in Bipolar Disorder

Most of the anti-anxiety medications that are primarily intended to treat anxiety are called benzodiazepines.

Many of these anxiety medications are also prescribed for other conditions as well such as:

  • Agitation
  • Insomnia
  • Chemotherapy-induced nausea and vomiting
  • Alcohol withdrawal
  • Seizures

Some of these medications are used primarily for their sedative effects, either to help with insomnia or as relaxation medications prior to surgery.

Benzodiazepine medications include:

  • Valium (diazepam)
  • Ativan (lorazepam)
  • Klonopin (clonazepam)
  • Serax (oxazepam)
  • Librium (chlordiazepoxide)
  • Xanax (alprazolam)
  • Dalmane (flurazepam)
  • Halcion (triazolam)
  • Restoril (temazepam)

Side effects of benzodiazepines are numerous, but of most concern is the issue of dependence, as well as overdose when used alone or with alcohol.

Antidepressants Used for Anxiety in Bipolar Disorder

Many antidepressant medications have been found to have a beneficial effect on anxiety, and unlike benzodiazepines, do not carry the same risk of abuse and overdose. For this reason, these drugs are often the mainstay of treatment of anxiety of any form. Drugs from different classes of antidepressants are commonly including:

Selective serotonin reuptake inhibitors (SSRIs) - Some of the drugs in this category are mentioned below along with some of the indications. That said, all of these may be considered for treatment of anxiety depending on your particular symptoms.

  • Paxil (paroxetine) - Paxil has many uses, including major depressive disorder, obsessive-compulsive disorder (OCD), panic disorder with or without agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD).
  • Zoloft (sertraline) - Zoloft is approved for the treatment of a number of disorders including major depressive disorder, OCD, panic disorder, premenstrual dysphoric disorder, and social anxiety disorder.
  • Prozac (fluoxetine) - Prozac is approved for treating depression, OCD, and panic disorder.
  • Luvox (fluvoxamine) - Luvox is commonly used to treat obsessive-compulsive disorder (OCD).

Selective norepinephrine reuptake inhibitors (SNRSs) - Drugs which inhibit the reuptake of both the neurotransmitters serotonin and norepinephrine may also be used to treat anxiety. SNRI's include:

Tricyclic Antidepressants - The older tricyclic antidepressants are used less often for the treatment of anxiety with bipolar disorder, but may be helpful in certain circumstances.

Other Medications Which May be Used for Anxiety - Buspar (buspirone) is unrelated to the medications above but may be helpful for anxiety with bipolar disorder, especially when combined with an antidepressant. While this medication generally has few side effects, there are some reports of mania on this drug, especially when combined with other medications.

Other Treatments for Anxiety

There are several other ways to approach the treatment of anxiety in addition to medications, and, in fact, a combination of treatments is most often the best approach. Other treatments may include:

As a final thought, keep in mind that all anxiety is not bad, and anxiety or "eustress" actually motivates people to be all they can be. Take a look at some of the positive benefits of living with anxiety.

Bottom Line on Treating Anxiety in Bipolar Disorder

If a bipolar person also has one or more anxiety disorders, it's likely that an appropriate anti-anxiety medication will be prescribed. Any of the above medications may be prescribed for someone with bipolar disorder who also suffers from anxiety, even if the anxiety is not from an actual anxiety disorder.

Sources:

Fountaoulakis, K., Yatham, L., Grunze, H. et al. The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm. International Journal of Neuropsychopharmacology. 2016 Dec 22. (Epub ahead of print).

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