Prescription Anxiety Reliever
In the quest for relief from debilitating anxiety, many individuals turn to medication. But is this the best course of action? While medication can certainly offer temporary respite, it is essential to understand the pros, cons, and potential risks associated with these drugs.
The Role of Medication in Anxiety Treatment
When faced with overwhelming panic, crippling fear, or sleepless nights spent worrying, the temptation to seek relief is understandable. In situations where anxiety is significantly impacting daily life, medication may provide some assistance, particularly in the short term. However, it is crucial to consider whether these drugs are always the most suitable choice.
Several types of medications are employed in the treatment of anxiety disorders. Among them are traditional anti-anxiety drugs, such as benzodiazepines, and newer options like selective serotonin reuptake inhibitors (SSRIs), which are more commonly recognized as antidepressants commonly recommended for long-term anxiety management. These medications can offer temporary relief, but they also come with potential side effects and safety concerns – some significant.
It is essential to acknowledge that these medications are not a cure, and there are many questions about their long-term effectiveness. For instance, benzodiazepines can lose their therapeutic anti-anxiety effect after 4 to 6 months of regular use, as reported by the American Academy of Family Physicians. Furthermore, a recent analysis published in JAMA Psychiatry suggests that the effectiveness of SSRIs in treating anxiety may be overestimated, and in some cases, they are no more effective than a placebo.
Given the potential for difficulty in weaning off anxiety medications, it is vital to approach their use with caution. Withdrawal from these drugs can result in rebound anxiety that can be more severe than the initial problem.
I Need Relief, and I Need It Now!
So, what are the options when immediate relief seems necessary? Even when relief comes with side effects and potential dangers, the allure of respite from panic and fear can be compelling.
Ultimately, the decision lies in the balance between the benefits and drawbacks of each treatment option. There are times and places where medication may prove helpful, particularly in the short term for severe anxiety that hinders functionality. However, many individuals opt for anti-anxiety medication when therapy, exercise, or self-help strategies would work just as well, if not better, without the accompanying drawbacks.
Medication Options for Anxiety
The primary types of medications prescribed for anxiety management include benzodiazepines, SSRIs, and serotonin-norepinephrine reuptake inhibitors (SNRIs). Other medications, such as buspirone, beta blockers, and bupropion, may also be utilized.
Benzodiazepines
Benzodiazepines, known as tranquilizers, are the most commonly prescribed type of medication for anxiety. Examples include Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), and Ativan (lorazepam). These drugs have a rapid onset of action, typically providing relief within 30 minutes to an hour, making them highly effective during a panic attack or another acute episode of anxiety.
However, they are physically addictive, and due to the potential for abuse, they are not recommended for long-term treatment. Benzodiazepines work by slowing down the nervous system, helping individuals relax both physically and mentally. Unfortunately, this action can also lead to several unwanted side effects, with the intensity of these effects increasing with higher doses.
Common side effects include:
- Drowsiness
- Dizziness
- Poor balance or coordination
- Slurred speech
- Trouble concentrating
- Memory problems
- Confusion
- Stomach upset
- Headache
- Blurred vision
In addition, benzodiazepines can exacerbate depression and potentially contribute to treatment-resistant depression. Moreover, they can cause emotional blunting or numbness and increase suicidal thoughts and feelings.
Safety Concerns and Withdrawal
Due to the risk of abuse and the development of tolerance, benzodiazepines are generally not recommended for long-term use. When used regularly, these drugs lead to physical dependence and tolerance, requiring increasingly larger doses to achieve the same anxiety relief.
Withdrawal from benzodiazepines can be particularly challenging, with symptoms including increased anxiety, restlessness, shaking, insomnia, depression, confusion, and in severe cases, seizure. Gradually tapering off the drug can help mitigate these withdrawal reactions.
Further concerns include drug interactions and overdose. Benzodiazepines can be dangerous and even deadly when combined with other central nervous system depressants, such as alcohol or sleeping pills. It is essential to discuss potential drug interactions with a doctor or pharmacist before combining medications.
SSRI Antidepressants
Many medications initially developed to treat depression are also prescribed for anxiety management. SSRIs, such as Prozac and Zoloft, are the most prevalent among them. Unlike benzodiazepines, the risk of dependency and abuse is lesser with SSRIs. However, these drugs take up to 4 to 6 weeks to begin alleviating anxiety symptoms, so they are not suitable for on-demand use.
Common side effects of SSRIs include:
- Fatigue
- Nausea
- Agitation
- Drowsiness
- Weight gain
- Diarrhea
- Insomnia
- Sexual dysfunction
- Nervousness
- Headaches
- Dry mouth
- Increased sweating
SNRI Antidepressants
SNRIs, such as Cymbalta, Yentreve, and Effexor, are another type of antidepressant often prescribed for anxiety. Unlike SSRIs, SNRIs increase serotonin as well as norepinephrine, leading to similar effectiveness but potentially more side effects.
Common side effects of SNRIs include:
- Temporary increase in anxiety
- Sexual side effects, such as sexual dysfunction
- Restlessness
- Headaches
- Insomnia
- Nausea
- Elevated blood pressure
Withdrawal
Although physical dependence is less rapid with antidepressants, withdrawal from these drugs can still pose a challenge. Quick discontinuation can trigger symptoms such as extreme depression and fatigue, irritability, anxiety, flu-like symptoms, and insomnia.
Antidepressant Medication and Suicide Risk
Antidepressants can worsen depression for some individuals, leading to an increased risk of suicide, hostility, and even homicidal behavior. While this risk is particularly high for children and young adults, anyone taking antidepressants should be closely monitored.
Other Types of Medication for Anxiety
In addition to the primary medications mentioned above, drugs such as buspirone, beta blockers, and bupropion may also be used in the treatment of anxiety.
Buspirone
Buspirone, also known by the brand name BuSpar, is a newer anti-anxiety drug that acts as a mild tranquilizer. It works by increasing serotonin in the brain and decreasing dopamine, making it less sedating and less likely to impair memory or coordination compared to benzodiazepines. Its effectiveness is limited to generalized anxiety disorder (GAD), and its withdrawal effects are generally minimal.
Common side effects of buspirone include:
- Nausea
- Headaches
- Dizziness
- Drowsiness
- Weight gain
- Upset stomach
- Constipation
- Nervousness
- Diarrhea
- Dry mouth
Beta Blockers
Beta blockers, such as propranolol (Inderal) and atenolol (Tenormin), are typically used to treat high blood pressure and heart problems. However, they can also be prescribed off-label for anxiety management. Beta blockers work by blocking the effects of norepinephrine, a stress hormone involved in the fight-or-flight response, helping to control the physical symptoms of anxiety, such as rapid heart rate, a trembling voice, sweating, dizziness, and shaky hands.
Since beta blockers do not affect the emotional symptoms of anxiety, they are most helpful for phobias, particularly social phobia and performance anxiety. If you are anticipating an anxiety-producing situation, such as giving a speech, taking a beta blocker in advance can help alleviate your “nerves.”
Common side effects of beta blockers include:
- Dizziness
- Sleepiness
- Weakness
- Fatigue
- Nausea
- Headache
- Constipation
- Diarrhea
Bupropion
Bupropion (known by the brand names Wellbutrin, Forfivo, and Zyban) is an antidepressant. There is some evidence that it may also be useful for anxiety and panic disorders. Its impact on anxiety varies depending on the dose, and it may worsen anxiety for some individuals.
Common side effects of bupropion include:
- Dizziness
- Nausea
- Dry mouth
- Drowsiness
- Anxiety
- Insomnia
- Loss of appetite
- Headache
Hydroxyzine
Hydroxyzine is an antihistamine often used to treat allergic reactions. However, it can also be used to manage anxiety symptoms such as tension and nervousness. It works by altering the levels of histamine and serotonin in the body, providing relief for GAD and potentially being similar in efficacy to benzodiazepines and buspirone.
Common side effects of hydroxyzine include:
- Dry mouth
- Dizziness and confusion
- Headache
- Constipation
- Drowsiness
Additional Treatment Options for Anxiety
Anxiety medication may offer some relief, but it will not solve problems caused by financial stress, an unhealthy relationship, or a negative mindset. It is essential to seek non-drug treatments for these underlying issues to achieve lasting change.
Self-help, therapy, and lifestyle changes can all play critical roles in managing anxiety. For example:
- Exercise: Regular physical activity can alleviate anxiety symptoms as effectively as medication.
- Worry-busting strategies: Training the brain to stop worrying and adopt a more balanced, calm perspective can be beneficial.
- Therapy: Cognitive behavioral therapy can equip individuals with the tools to manage their anxiety levels, challenge negative thought patterns, and overcome fears.
- Yoga and tai chi: These mind-body interventions can help address anxiety from an emotional, psychological, and spiritual standpoint.
- Mindfulness and meditation: Mindfulness can create a state of awareness and non-judgment that often brings a sense of calm and relaxation.
Making an Informed Decision
Whether to treat anxiety with medication requires careful consideration of the benefits and drawbacks, both by the individual and their mental health professional. It is essential to understand the common side effects of the medication under consideration. Side effects range from mild annoyances, such as dry mouth, to more severe problems like acute nausea or pronounced weight gain. The decision should be based on a balanced assessment of the side effects versus the benefits.
When considering anxiety medication, ask yourself and a mental health professional questions such as:
- "Is medication the best option for my anxiety problem?"
- "Am I willing to endure unpleasant side effects in exchange for anxiety relief?"
- "What non-drug treatments for anxiety might be effective?"
- "Do I have the time and am I willing to pursue non-drug treatments like cognitive-behavioral therapy?"
- "If I decide to take anxiety medication, should I additionally pursue therapy?"
- "Is anxiety genuinely my issue, or could something else be at play, such as an underlying health condition or pain?"
Additional questions to ask your doctor include:
- "How will the medication help my anxiety?"
- "What are the drug's common side effects?"
- "Are there any food and drinks I'll need to avoid?"
- "How will this drug interact with my other prescriptions?"
- "How long will I have to take the anxiety medication?"
- "Will withdrawing from the medication be difficult?"
- "Will my anxiety return when I stop taking the medication?"
- In the realm of health-and-wellness, mental health, and anxiety management, it's crucial to recognize that medication might not always be the optimal choice, despite its temporary relief capabilities.
- Science warns that the long-term effectiveness of anxiety medications like SSRIs and benzodiazepines may be questionable, with the potential for unwanted side effects and safety concerns.
