Medications for Anxiety Disorders

The Four Major Classes of Anxiety Medications

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If you have an anxiety disorder, this sometimes helpful emotion can keep you from coping and may even disrupt your daily life. Anxiety disorders are more than just a case of nerves. They are illnesses, often related to the biological makeup and life experiences of the individual, and they frequently run in families. Fortunately, there are a number of medications available to treat the symptoms of anxiety disorders.

 

Symptoms of Anxiety Disorders

Generally, symptoms prominent in anxiety disorders include irritability, uneasiness, jumpiness, feelings of apprehension, rapid or irregular heartbeat, stomachache or nausea, faintness and/or breathing problems. These symptoms vary depending on the person and the diagnosed anxiety disorder.

Types of Anxiety Disorders

There are a number of anxiety disorders, each with its own distinct features and symptoms. The most common are generalized anxiety disorder (GAD), social anxiety disorder (SAD). panic disorder, phobias, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).

Medications Used to Treat Anxiety Disorders

Using medications for anxiety disorder is considered safe and effective and may even be particularly helpful when used along with psychotherapy. There are four major classes of medications that mental health professionals use to treat anxiety disorders: selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), benzodiazepines and tricyclic antidepressants (TCAs).

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors work by causing more serotonin to be available in the brain, which improves your mood. SSRIs like Prozac (fluoxetine), Luvox (fluvoxamine), Paxil (paroxetine) and Zoloft (sertraline) are good choices for any type of anxiety disorder.

In general, side effects can include weight gain, sleeping difficulties (too much or too little) and sexual dysfunction. Many side effects go away within a couple weeks of beginning the medication, however, so give your body time to adjust.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Serotonin-norepinephrine reuptake inhibitors work similarly to SSRIs in that they cause the level of serotonin, as well as norepinephrine, to be higher in the brain. Examples are Cymbalta (duloxetine), Effexor (venlafaxine) and Pristiq (desvenlafaxine). SNRIs are considered just as effective as SSRIs, especially for generalized anxiety disorder. Side effects may include headaches, sexual dysfunction, insomnia, upset stomach and increased blood pressure.

Benzodiazepines

Benzodiazepines, or sedatives, are usually used for a short period of time to help you relax and get rid of muscle tension and other physical symptoms that may come with anxiety. Common benzodiazepines include Klonopin (clonazepam), Xanax (alprazolam), Valium (diazepam) and Ativan (lorazepam).

Benzodiazepines can generally relieve symptoms within a short time.

Different people respond differently to benzodiazepines. Some people may need to take them two or three times a day, and others only once a day, or on an as-needed basis. The dose is generally started at a low level and gradually raised until symptoms are diminished or removed. The dose will vary a great deal depending on the symptoms and your body chemistry. Benzodiazepines are sometimes given on an as-needed basis just for stressful situations or anxiety attacks.

Use Caution With Benzodiazepines

Long-term use of benzodiazepines is not recommended because you can develop tolerance and/or dependence. Tolerance means that you need to take more of the medication in order for it to work. Dependence means that you develop withdrawal symptoms if you stop taking the medication. Some people abuse these medications in order to get high. Longer-acting medications such as Klonopin or Valium may produce milder withdrawal symptoms than short-acting medications like Xanax and Ativan.

You should abstain from alcohol when taking benzodiazepines, because the interaction between benzodiazepines and alcohol can lead to serious and possibly life-threatening complications. Be sure to tell your doctor about other medications you are taking.

Be sure to talk with the doctor before discontinuing a benzodiazepine. A withdrawal reaction may occur if the treatment is stopped abruptly. Withdrawal symptoms may include anxiety, shakiness, headache, dizziness, sleeplessness, loss of appetite and/or seizures.

Ironically, many of these symptoms are similar to the anxiety symptoms that you may have sought treatment for. To avoid these symptoms your doctor will probably taper your medication dose gradually.

Tricyclic Antidepressants (TCAs)

The last class of medications used for anxiety is tricyclic antidepressants. Because these medications were some of the first antidepressants developed, they can have severe side effects, including blurry vision, dry mouth, constipation, blood pressure drop when standing up and urinary difficulties. Examples of TCAs are Elavil (amitriptyline), Tofranil (imipramine) and (Pamelor) nortriptyline.

Be sure to take your medications exactly as prescribed by your doctor. If you are having serious side effects, consult your doctor, but do not stop your medication without your doctor's approval as this can cause serious health issues.

Sources:

http://www.adaa.org/understanding-anxiety/DSM-5-changes

http://www.adaa.org/finding-help/treatment/medication

http://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20044970

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