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The Reasons Treat Anxiety Is More Difficult Than You Imagine
Meds That Treat Anxiety

Anxiety is among the most frequent mental health problems that affects 40 million adults in the United States. It is extremely treatable, and there are numerous medications available.

SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), like Zoloft, Prozac, Lexapro and Effexor, work to alleviate anxiety by raising levels of the chemical serotonin in the brain. Unlike benzodiazepines, they're not addictive.

SSRIs

The most common anxiety medication is selective serotonin reuptake inhibits (SSRIs) which include citalopram, escitalopram, and fluoxetine. These medications are also used to treat depression and alleviate symptoms of anxiety disorders such as obsessive compulsive disorder. They may take up to a month for them to begin to work.

These drugs increase the amount of certain chemical messengers in the brain, including serotonin and norepinephrine. They are usually the first option for anxiety, however doctors also use other types of antidepressants as well as benzodiazepines.

Another class of antidepressants, called serotonin and norepinephrine receptor inhibitors (SNRIs) such as duloxetine (Cymbalta) and venlafaxine (Effexor) are used to treat anxiety. They function a bit differently than SSRIs because they reduce the reabsorption of norepinephrine as well as serotonin, although at lower levels than SSRIs. These medications can take a while to start taking effects, and also tend to be more expensive than SSRIs.

Tricyclic antidepressants (TCAs) such as imipramine (Tofranil) can be effective in treating some anxiety disorders, particularly GAD. Their drowsiness, as well as other adverse effects, make them less popular. Another kind of antidepressant, monoamine oxidase inhibitors (MAOIs) are also able to be used to combat anxiety. However, their restrictions on diet and the high risk of toxicity limit their use.

Benzodiazepines are frequently used to treat panic attacks and anxiety in the short-term like when you wait for SSRIs or SNRIs to begin working. These drugs can lead to addiction to tolerance, sedation, and dependence as well as withdrawal symptoms like a rebound anxiety, depression, and delirium. Benzodiazepines can be found in alprazolam as well as clonazepam and lorazepam.

Therapy is a crucial component of the treatment for anxiety as it can help you learn more about your symptoms and the causes. Many people find that both therapy and medication help them manage their anxiety. Certain studies have demonstrated that cognitive behavioral therapy is as effective as anxiety medications. Consult your physician to find out what's best for you.

Benzodiazepines

Benzodiazepines create an calming effect, which can reduce anxiety and relax muscles that are tense. They also alleviate symptoms of bodily stimulation related to fear (like heart racing or trembling) and help promote sleep.

They work by binding inhibitory neurons, such as GABA or gamma aminobutryic acid at receptors in the central nervous system. They enhance GABA's effects by facilitating the inhibitory effect of GABA on other neurotransmitters, and by reducing the volume of messages sent to amygdala. It is a part of the brain which assesses the threat and triggers a feeling of fear.

These medications are sometimes used for short periods like panic attacks or an anxiety episodes. They may help relieve symptoms within 30 to 90 minutes of taking them. Benzodiazepines are different from SSRIs aren't able to remain in the body for long. They are fast-acting and often work in a matter of hours, which makes them ideal for situations when you require quick relief (like during an airplane flight or before giving an address in public).

They are addictive, and people are generally only prescribed them for a maximum of 4 weeks at a time. After that time they also lose their effectiveness.

One of the reasons benzodiazepines became so popular is that they worked and had a few adverse effects, when compared to their predecessors, such as meprobamate and barbiturates. They have a quick onset of action and are very useful as anxiolytics (anti-anxiety), sedatives and anticonvulsants as well as as muscle relaxants.

Benzos were blamed for negative attitudes towards anxiety that emerged in the 1970s and 80s, including the minimization of the disorder, and the belief that benzodiazepine treatment lead to physical dependence. However they still play an important role in the treatment of anxiety disorders, especially in combination with psychosocial interventions, such as cognitive behavioral therapy and interpersonal therapy.

Benzos can interact with other medications and trigger undesirable side effects, like drowsiness or confusion. It is recommended to inform your doctor about any prescription, nonprescription, or herbal medicines you currently take or plan to take. You can determine which medications are safe to use with benzodiazepines by checking the British National Formulary A-Z list of drug interactions.

Antidepressants

Antidepressants are effective in treating anxiety and other mental disorders. According to the Anxiety and Depression Association of America, antidepressants -- like SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs) -- can help reduce chronic anxiety disorder, obsessive-compulsive disorder (OCD), panic disorders and generalized anxiety disorder (GAD). The FDA has approved antidepressants for other health conditions, including eating disorders, bipolar disorder, and certain types of pain.

The majority of doctors prescribe SSRIs as the first-line treatment for anxiety, however these medications may not be appropriate for all people. If the antidepressants do not work the doctor might suggest an older version known as a tetracyclic or tricyclic antidepressant. These include amitriptyline and nortriptyline, clomipramine and dothiepin, doxepin, trimipramine or imipramine. These antidepressants aren't as common but are still readily available. Your doctor can prescribe the sedating antidepressant Trazodone (Desyrel) in lower doses to treat anxiety or insomnia.

Other antidepressants that may help include Nefazodone (Ferdinand) and duloxetine (Cymbalta). They're also available in generic form. If they aren't helping your doctor, you can try the antipsychotics quetiapine and olanzapine or the tranquilizing antidepressant Mirtazapine.

Beta blockers are used to treat other anxiety disorders. They lower blood pressure and heart rate by blocking adrenaline. These medications aren't typically used to treat anxiety on their own however they can be beneficial when combined with psychological therapy.

Psychological therapy can help you overcome negative thoughts and behaviors that can cause anxiety. It can help you manage your anxiety and teach you how to cope. Depending on your situation, you may be treated with exposure or cognitive behavioural therapy. Cognitive behavioural therapy teaches you to challenge negative and fearful thoughts and overcome your avoidance of situations which trigger anxiety. Exposure therapy involves increasing the anxiety-inducing situations until they become manageable. It can be done either individually or in small groups. In both instances, the results take time to appear. Some people believe that the combination of medication and psychotherapy is the best choice. Some people find that medication alone is enough to manage symptoms. Discuss with your doctor how you manage your symptoms.


Other Medicines

Other drugs can also help relieve your symptoms. Beta blockers, antihistamines and buspirone are often prescribed to alleviate anxiety.

These drugs correct an imbalance in the brain's chemicals and can alleviate your symptoms by reducing or blocking the signals that can cause stress and fear. But, they're not the only solution. You'll still need to do other things to manage your anxiety, including exercises or relaxation techniques, as well as psychological therapy.

alternative treatments for anxiety may initially prescribe one of the "first choice" anxiety medications, which are SSRIs and SNRIs. According to research, these medications are the most effective for treating anxiety disorders. SSRIs are typically found in sertraline (Zoloft) as well as fluoxetine, citalopram, and escitalopram. These drugs may cause mild side effects, such as insomnia or nausea, but they typically disappear within 4-8 weeks. Contrary to benzodiazepines they're not addictive and do not increase the risk of suicidal thoughts.

The benzodiazepines such as alprazolam diazepoxide and clonazepam (Valium), provide immediate relief from panic and anxiety attacks. However, they may cause side effects, such as drowsiness and dizziness. They can also cause memory and coordination issues, and even dependence. They're not as popular than the barbiturates of the past, but they're just as effective.

Antihistamines, such as Vistaril (hydroxyzine) were initially designed to help with allergies. However they also serve to ease anxiety symptoms. Hydroxyzine may have a relaxing effect because it blocks histamine receptors. It's not a controlled drug which means it doesn't carry the same dangers of addiction like benzodiazepines.

Anticonvulsants are a different kind of medication that can help with anxiety. They have been found to reduce anxiety by interfering in the production and release of dopamine as well as sérotonin. These medications may be prescribed as a part of a combination therapy or to treat anxiety in the short-term. Your doctor will evaluate your symptoms and health history to determine if these drugs are right for you. They will also discuss the length of time you'll need to take these medications as well as any possible adverse effects that could occur. Anxiety medications are only available on prescription, which means you'll have to see a psychiatrist to get them.