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An Introduction to Anti-Anxiety Medication

By Krissi Maarx

Medications can provide relief from panic and anxiety and help you cope with stressful situations. But because anti-anxiety medications do not “cure” the problem or underlying condition, they are only one aspect of an effective treatment plan and may not even be necessary. If you feel that you will benefit from prescription medication, talk with your psychiatrist, and review the options, side effects, and considerations to decide whether they are appropriate for you.

Types of Anti-Anxiety Medication

Psychiatrists prescribe different types of medication depending on your medical history, susceptibility to addiction, the severity of your symptoms, and the presence of other disorders, such as depression. They generally prescribe the following types of medication for anxiety disorders.

Benzodiazepines

The most popular and widely recognized anxiety medications are benzodiazepines, which come in more than 15 varieties, according to the Center for Substance Abuse Research. The commonly prescribed medications from this class include Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam), Librium (chlordiazepoxide), and Klonopin (clonazepam).

Considered a controlled substance, benzodiazepines increase the neurotransmitter gamma-amino butyric acid (GABA), which then promotes relaxation by slowing your nerve impulses.

Lower doses ease anxiety and tension, and higher doses act as a sedative, though different medications from this family may target different receptors in the brain. Some varieties provide instant relief from symptoms and exit the body quickly, whereas others are long-acting medications that accumulate in the body.

Because they can relieve symptoms quickly, “benzos” are often helpful for panic attacks.

Buspar

Buspar, or buspirone hydrochloride, is in a class of its own. It affects neurotransmitters and is a mild tranquilizer, but its active mechanism is unknown. This medication relieves anxiety symptoms and is sometimes preferable when there is co-occurring depression. Unlike benzodiazepines, Buspar is not habit forming and does not have a sedative or muscle relaxant effect.

While benzodiazepines can provide fast relief and be taken on an as-needed basis, Buspar is a long-acting drug that you must take consistently. This is usually prescribed for generalized anxiety disorder (GAD).

Antidepressants

A few classes of antidepressants also offer relief from anxiety symptoms. However, like Buspar, they are long-acting medications, and you must take them consistently to achieve a steady effect. You may not feel any relief for up to the first 6 weeks of an antidepressant regimen.

The most common antidepressants for anxiety treatment are selective serotonin reuptake inhibitors (SSRIs). These block the reuptake of serotonin (a “feel-good” neurochemical) in the brain, which then leaves you with an increased level of it to improve your mood. Medications from this class include Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Lexapro (escitalopram), and Celexa (citalopram).

Tricyclic or tetracyclic antidepressants affect three “feel-good” neurotransmitters: serotonin, norepinephrine, and dopamine. This class of medications includes Elavil (amitriptyline), Sinequan (doxepin), Effexor (venlafaxine), and Remeron (mirtazapine).

Monoamine oxidase inhibitors (MAOIs) for anxiety include Nardil (phenelzine) and Parnate (tranylcypromine). MAOIs are typically not the first choice of medication for anxiety, as they have a delayed onset, require strict dietary restrictions, and interact poorly with other medications.

Psychiatrists generally prescribe antidepressants for obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), and panic disorder.

Beta Blockers

Although beta blockers are prescribed for heart and blood pressure problems, they also relieve the physical symptoms of anxiety by reducing the effect of stress hormones. While they do not alter emotions or mental anxiety, they do control your heart rate, trembling, and dizziness in anxiety-inducing situations. They are fast-acting drugs, so you would take them for temporary help as needed.

Beta blockers for anxiety include Tenormin (atenolol) and Inderal (propranolol). These medications may be helpful with phobias and performance anxiety, according to HelpGuide.org.

Considerations When Taking Anti-Anxiety Medications

Before taking any type of medication for an anxiety disorder, it’s important that you discuss its side effects with your physician or psychiatrist. Many medications, especially benzodiazepines, cause drowsiness and can interfere with your ability to function in everyday activities.

Use of benzodiazepines and antidepressants can also cause serious side effects, including rage, hallucinations, and suicidal ideations. Because some of the medications are habit forming, you may experience uncomfortable withdrawal symptoms if you stop taking them.

If you are already taking these medications and feel that you can cope without them, consult your doctor. You may be able to gradually wean yourself off the medication with your doctor’s approval.

While anti-anxiety medications can be helpful and effective with relieving symptoms, they are ideally a short-term aid. It’s important that you address the underlying source of your anxiety as you make an effort to recover from it. With the help of cognitive-behavioral therapy (CBT), you may be able to develop healthier thought patterns and behaviors that eliminate the need for medication.

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