Modern Medication
Anxiety Treatment Reference
Psychiatrists or other physicians can prescribe medications for Anxiety
Disorder. These doctors often work closely with psychologists, social workers,
or counselors who provide psychotherapy. Although medications won't cure
Anxiety Disorder, they can keep the symptoms under control and enable you
to lead a normal, fulfilling life.
The major classes of medications used for various anxiety disorders are
described below.
Antidepressants
A number of medications that were originally approved for treatment of depression
have been found to be effective for Anxiety Disorder. If your doctor prescribes
an antidepressant, you will need to take it for several weeks before symptoms
start to fade. It is important not to get discouraged and stop taking these
medications before they've had a chance to work.
Some of the newest antidepressants are called selective serotonin reuptake
inhibitors, or SSRIs. These medications act in the brain on a chemical messenger
called serotonin. SSRIs tend to have fewer side effects than older antidepressants.
People do sometimes report feeling slightly nauseated or jittery when they
first start taking SSRIs, but that usually disappears with time. An adjustment
in dosage or a switch to another SSRI will usually correct bothersome problems.
It is important to discuss side effects with your doctor so that he or she
will know when there is a need for a change in medication.
Fluoxetine, sertraline, fluvoxamine, paroxetine, and citalopram are among
the SSRIs commonly prescribed for Anxiety Disorder. These medications are
started at a low dose and gradually increased until they reach a therapeutic
level.
Similarly, antidepressant medications called tricyclics are started at low
doses and gradually increased. Tricyclics have been around longer than SSRIs
and have been more widely studied for treating Anxiety Disorder. Many physicians
and patients prefer the newer drugs because the tricyclics sometimes cause
dizziness, drowsiness, dry mouth, and weight gain. When these problems persist
or are bothersome, a change in dosage or a switch in medications may be needed.
Monoamine oxidase inhibitors, or MAOI, are the oldest class of antidepressant
medications. The most commonly prescribed MAOI is phenelzine, which is helpful
for people with panic disorder and social phobia. Tranylcypromine and isoprocarboxazid
are also used to treat anxiety disorders. People who take MAOIs are put on
a restrictive diet because these medications can interact with some foods
and beverages, including cheese and red wine, which contain a chemical called
tyramine. MAOIs also interact with some other medications, including SSRIs.
Interactions between MAOIs and other substances can cause dangerous elevations
in blood pressure or other potentially life-threatening reactions. For this
reason, MAOIs are often a last resort.
Anti-Anxiety Medications
High-potency benzodiazepines relieve symptoms quickly and have few side
effects, although drowsiness can be a problem. Because people can develop
a tolerance to them—and would have to continue increasing the dosage
to get the same effect—benzodiazepines are generally prescribed for
short periods of time. People who have had problems with drug or alcohol
abuse are not usually good candidates for these medications because they
may become dependent on them.
Some people experience withdrawal symptoms when they stop taking benzodiazepines,
although reducing the dosage gradually can diminish those symptoms. In certain
instances, the symptoms of anxiety can rebound after these medications are
stopped. Potential problems with benzodiazepines have led some physicians
to shy away from using them, or to use them in inadequate doses, even when
they are of potential benefit to the patient.
Other Medications
Beta-blockers, such as propanolol, are often used to treat heart conditions
but have also been found to be helpful in treating Anxiety Disorder. When
a feared situation, such as giving a speech or dealing with a specific phobia,
can be predicted in advance, your doctor may prescribe a beta-blocker that
can be taken to keep your heart from pounding, your hands from shaking, and
other physical symptoms from developing.