Medication to Treat Anxiety Disorders.

Anxiety is often manageable and mild, but sometimes it can present serious problems. A high level or prolonged state of anxiety can make the activities of daily life difficult or impossible. Anti anxiety agents, or anxiolytics, may be used to treat anxiety disorders.

There are several different groups of prescribed drugs that can be used.

ANTIDEPRESSANTS

Antidepressants, used for treating depression as well, are very effective in treating the symptoms of certain anxiety disorders. Research shows that changes occur in the brain's chemicals when someone has an anxiety disorder. Antidepressants are designed to assist these chemicals to work effectively in the brain.

Some Antidepressants are:

• Citalopram (Celexa)
• Escitalopram (Lexapro, Cipralex)
• Paroxetine (Paxil, Seroxat)
• Fluoxetine (Prozac)
• Fluvoxamine (Luvox)
• Sertraline (Zoloft, Lustral)

There are also a number of other antidepressants that may be prescribed.

Take time to work:

It can take up to 2 to 3 weeks for the antidepressant to reach a high enough level in the brain. This means it can seem to take a long time before any improvement is felt. Most people (60-70%) will recover in 6 to 8 weeks of taking antidepressants. Antidepressants are non-addictive but if stopped abruptly they can cause some side effects, so it is best to reduce them prior to stopping. People usually stop or reduce the medication when they feel they have other coping strategies in dealing with anxiety. Most people take antidepressants for 6-12 months but it can be longer depending on the severity of symptoms and if they seem likely to return.

Possible side effects:

All medications have the potential to have side effects but they vary from person to person. This means a person may have no side effects or one or many. More side effects are listed in the packet of the antidepressant. Possible side effects of antidepressants are anxiety, nausea, headache, difficulty sleeping, sweating, dry mouth, loss of appetite, sexual dysfunction,drowsiness, dizziness and constipation. Some of these side effects disappear after a week or two of taking the antidepressant. For more information on antidepressants see our info. sheet on 'medications for depression'.

Precautions:

Alcohol and street drugs should be avoided or taken with caution when taking an antidepressant, as the effect is unpredictable (unknown). It is best to discuss with the prescribing doctor what other medications are being taken as they can have an effect on the antidepressant. Even “natural” medicines such as St John’s wort can interact with antidepressants.

BENZODIAZEPINES

Benzodiazepines or “benzos” are fast acting medications. Benzodiazepines act on brain chemicals helping to relax, calm and make you sleepy. They help to treat, but not cure, the symptoms of anxiety, such as tension, feeling shaky, sweating and difficulty in thinking straight. They also have muscle-relaxing properties.They are unlike antidepressant medications as, if used for a long period of time can be addictive and a person requires more and more over time to get the same effect. Benzodiazepines are often used to get a quick effect, for example, when a person is extremely panicky and waiting for other medications to work or to assist a person to cope better with a stressful/traumatic event. They are usually for short-term use only.

Some benzodiazepines are:

• Diazepam (Valium)
• Clonazepam (Klonopin)
• Oxazepam (Serepax)
• Lorazepam (Ativan)
• Alprazolam (Xanax)

There are also a number of other benzodiazepines that may be prescribed.

Take time to work:

Benzodiazepines are fast acting drugs that sedate so the symptoms of anxiety are often reduced in an hour after taking.

Possible side effects:

Some drowsiness or mental slowness may be experienced whilst taking benzodiazepines. Consequently, a person should not drive or operate machinery, especially if just starting treatment, until the effect of the benzodiazepine is established.

Precautions:

Like benzodiazepines, alcohol depresses the nervous system and when combined the effect is unpredictable. Its best to avoid alcohol use as drinking alcohol and using benzodiazepines can lead to serious and life threatening complications. It is best to check with the prescribing doctor about the way benzodiazepines react with other drugs.Benzodiazepines should not be stopped suddenly if taken for more than 2 weeks. If stopped suddenly a withdrawal reaction with unpleasant and severe symptoms such as headache, shakiness, muscular cramps, vomiting, fits and dizziness can occur. The person may also feel as if the anxiety is returning. When stopping a benzodiazepine after taking it for a long time, it needs to be gradually reduced to avoid experiencing withdrawal reaction.

OTHER MEDICATIONS USED TO TREAT ANXIETY

Buspirone

Buspirone (Buspar) is used for short-term treatment of anxiety disorders. It is as effective as benzodiazepines, but has less potential to cause sleepiness and dependency. It also does not appear to cause the withdrawal problems that benzodiazepines do, but does take longer to work, around one to two weeks.