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Medications for anxiety

A number of medications are used to treat the symptoms of anxiety disorders. These symptoms include

irritability
uneasiness
jumpiness
feelings of apprehension
rapid or irregular heartbeat
stomach ache or nausea
faintness
breathing problems.

If you have an anxiety disorder, this sometimes helpful emotion can keep you from coping and can 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. There are a number of anxiety disorders, each with its own distinct features.

A high level of anxiety or a prolonged state of anxiety can make the activities of daily life difficult or impossible. Both antidepressants and antianxiety medications are used to treat anxiety disorders. Many antidepressants are effective in anxiety disorders as well as depression. The first medication approved to treat OCD was the tricyclic antidepressant clomipramine (Anafranil). The SSRIs, fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft) have now been approved for use with OCD. Paroxetine has also been approved for social anxiety disorder (social phobia), GAD, and panic disorder; and sertraline is approved for panic disorder and PTSD. Venlafaxine (Effexor) has been approved for GAD.

The most important group of antianxiety medications are the benzodiazepines. This class includes clonazepam (Klonopin), alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan). Benzodiazepines can generally relieve symptoms within a short time. They have relatively few side effects: drowsiness and loss of coordination are most common; fatigue and mental slowing or confusion can also occur. These effects make it dangerous for people taking benzodiazepines to drive or operate some machinery. Other side effects are rare.

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. Dose is generally started at a low level and graually raised until symptoms are diminished or removed. The dose will vary a great deal depending on the symptoms and your body chemistry.

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.

Benzodiazepines are usually prescribed for short periods of time -days or weeks, They are sometimes given on an "as needed" basis just for stressful situations or anxiety attacks. If you take these medications for weeks or months you may develop tolerance 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. Some patients with severe anxiety may need long term treatment. Longer acting medications such as clonazepam (Klonopin) or diazepam (Valium) may produce milder withdrawal symptoms than short acting medications such as alprazolam (Xanax) and lorazepam (Ativan).

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
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.

Buspirone (BuSpar) is a medication specifically for anxiety disorders other than the benzodiazepines. It differs from the benzodiazepines in that it must be taken consistently for at least 2 in order to work. You can't take buspirone on an "as needed" basis.

Beta blockers such as propranolol (Inderal, Inderide) are sometimes used to control "stage fright" or other forms of performance anxiety. These medications are more commonly used to treat heart conditions and high blood pressure.