Purpose/Role of Medications

The purpose or role of medications is to reduce the feeling of anxiety within a person, they person takes the medication to feel less “anxious”, the symptoms of anxiety can be: Extreme fear, panic attacks and out of control worrying. When a person feels anxious, they are in an uneasy state; however, medication can help them calm down and relax. Additionally, different drugs have varying effects on individuals, which means it often takes time and patience to identify the most effective medication for managing anxiety. Furthermore, anxiety medications are generally considered effective and safe; nevertheless, their safety largely depends on how they are taken—specifically, whether they have been prescribed by a doctor or are being used without professional consultation. Using them without any prescription can be dangerous for the user.

Note: This article is for informational purposes only. Please consult a medical professional for any medication or medical needs.

What Are Common Anxiety Medications?

Benzodiazepines

The most commonly prescribed anxiety medications which help calm down a person or reduce the uneasiness are known as “benzodiazepines” or commonly known as Benzos or Anti-anxiety pills. Benzos are one of the drugs mostly prescribed for anxiety throughout the world and help relieve the physical symptoms that the person might be feeling, such as tensed muscles. They help the muscles relax and it redu

ces the excessive nerve activity which can make a person feel drowsy. It takes a few minutes for the user to feel the effects of benzos. 

Some common uses of Benzos:

• • Anxiety

• • Panic disorders

• • Seizures 

• • Sleeplessness 

• • Nervousness

• • Muscles spasms 

List of commonly used benzodiazepines medicines:

• • Xanax (Alprazolam)

• • Librium (Chlordiazepoxide)

• • Valium (Diazepam)

• • Ativan (Lorazepam) (1)

Selective Serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors or SSRIs are also considered to help reduce anxiety and are known to be prescribed to patients suffering from anxiety. They are sometimes considered as the first-line drug treatment for OCD and anxiety.  SSRIs work in such a way that they stop the nerve cells from absorbing back serotonin. Serotonin is a chemical which has an important task of regulating the mood. SSRIs’ take around 2 to 6 weeks to take effect. They aren’t deemed useful for everyone.(2)

Some common uses of SSRIs:

• • OCD (Obsessive compulsive disorder)

• • GAD (Generalized anxiety disorder)

• • Severe Phobias such as agoraphobia or social phobia

• • PTSD (Post-traumatic stress disorder)

List of commonly used SSRIs medicines:

• • Citalopram (Celexa) 

• • Escitalopram (Lexapro) 

• • Fluoxetine (Prozac) 

• • Fluvoxamine (Luvox)

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Similar to SSRIs, these are another class of anti-anxiety and anti-depression medications. Additionally, they work by reducing the reabsorption of serotonin and norepinephrine chemicals in the brain. Moreover, to feel the effect of SNRIs, it typically takes 2 to 6 weeks, although this timeframe can vary from person to person.

List of commonly used SNRIs for anxiety: 

• • Venlafaxine (Effexor XR)

• • Duloxetine (Cymbalta)

Tricyclic antidepressants (TCAs)

TCA’s are approved by the FDA to treat several types of:

• • Anxiety

• • Depression 

• • OCD

• • Bedwetting

List of commonly used TCAs:

• • Amitriptyline (Elavil)

• • Nortriptyline (Pamelor)

• • Imipramine (Tofranil)

Some other medications which the doctors might provide to the patient if the above mentioned medicines have no effect on the patient.

Beta-blockers

These are mainly used to treat people with high blood pressure or people who have heart conditions. But often, they can be prescribed to people experiencing anxiety. Some physical symptoms that the patient might be feeling can be reduced through this medication, as it reduces the effect of the chemical norepinephrine. Some commonly used Beta-blockers are: Atenolol (Tenormin) & Propranolol (Inderal)

Buspirone (BuSpar)

It can be used to treat both short term or long term anxiety problems. Buspirone when compared to benzos is much slower, and isn’t able to treat all types of Anxiety disorders. But the side effects are less as compared to the other medications and there’s a lower risk of dependency.(3)

Monoamine oxidase inhibitors (MAOIs)

These are the earliest edition of antidepressants that were available to the common man. They can be used to treat social phobia and panic disorder. Not everyone can benefit from their use.

List of commonly used MAOIs:

• • Isocarboxazid (Marplan)

• • Phenelzine (Nardil)

• • Selegiline (Emsam)

• • Tranylcyprimine (Parnate)

What Are the Side Effects, Safety Concerns, FDA Warnings, Risks of Drug Abuse, Withdrawal, Interactions, and Overdose?

If you are using medications to treat your anxiety, there’s a potential chance that you may experience some side effects. They are experienced by the patients after he/she has been using the medication for a long time. They often resolve themselves after a few weeks of not using the medication. But if the side effects are intolerable and aren’t going away or their intensity is not reducing, it is crucial to go get a check-up from a doctor.

It is recommended by the doctors that anxiety medications should be taken with food, so the side effects can be reduced. The medication can also be taken before going to med, but make sure it doesn’t interfere with your sleep pattern. The side effects of a medication that you experience, varies from person to person. It also depends on the type of drug you were taking and how long you have been taking that medication.

BDZ side effects:

• • blurry vision

• • confusion

• • dizziness

• • depression

• • drowsiness or fatigue

• • headaches

• • loss of memory or concentration

Since there is a risk of developing physical dependency on BDZ, FDA has required a Boxed Warning for all benzodiazepines medicines. When the BDZ medication is abused by the user, it can lead to addiction. When reducing the dosage too quickly after a long time, it can lead to withdrawal symptoms such as seizures, insomnia, sweating, which can be dangerous and life threatening in some situations. Taking in excessive quantities, or using the drug with some other substances, can lead to a serious risk of OD.

SSRIs side effects:

• • blurry vision

• • dizziness

• • drowsiness or fatigue

• • dry mouth

• • feeling agitated or restless

• • gaining weight

• • headaches

• • nausea

FDA also requires it to have a Boxed Warning. People using these drugs may start to develop suicidal thoughts, particularly when using for the first few weeks. A person who has just stopped taking SSRI medication may experience depression, nausea, fatigue, electric shock sensations etc. If an overdose of SSRIs is taken, rarely there’s a situation where it’s considered fatal. 20 to 80 mg per day is the normal dosage, a dose higher than 520 mg can have a lethal outcome.

SNRIs side effects:

• • constipation

• • dizziness

• • drowsiness or fatigue

• • dry mouth

• • headaches

• • increased blood pressure

• • weight gain

• • loss of appetite

• • nausea

As approved by the FDA, SNRIs can be used to treat depression. But since it’s an antidepressant, it’s required to have a Boxed warning. It is not considered addictive, but stopping the medication can allow the patient to develop some withdrawal like symptoms. 

TCA’s side effects:

• • blurry vision

• • constipation

• • difficulty urinating

• • dry mouth

• • drowsiness

• • increase in appetite

• • lightheadedness

• • low blood pressure after standing up

FDA requires this medicine to have a Black Box warning. It increases suicidal thinking in children/ teenagers and adults. They aren’t considered addictive, however, when a user stops taking them, they can experience some withdrawal like symptoms.(4)

What Are Alternative Treatments to Anxiety Medication? 

Having too much coffee in a day can reduce your ability to handle anxiety in an efficient way. If you don’t want to go for the above mentioned medications, you can limit your caffeine intake which will help decrease your blood pressure and your heartbeat rate thus decreasing the possibility for a panic attack.

Avoid alcohol and nicotine as temporary anxiety relief; their effects fade, often worsening symptoms over time. Instead, prioritize a balanced diet and adequate water intake to support overall well-being and anxiety management. Eating healthy food will help you ease your anxiety and you will be able to handle stress in a more effective way. Unhealthy food can cause more stress on your body. To have a healthy mind and healthy thoughts, you need water which is a major constituent of your body. Drinking more water can help you relieve stress.

Doing regular exercise or hitting the gym can help you solve the problem of anxiety and make you less anxious. It can help you structure your thoughts and can reduce overthinking on a great level.

Not having enough sleep can make a person feel more stressed, at least 7-8 hours of sleep is required by the human body to function more efficiently.

Meditation, breathing techniques and Yoga are the other things which can also relieve anxiety.(5)

How Do You Decide?

You can visit a doctor and then decide if medication is the right option for you. You have many choices and it’s solely your decision, the doctor is just there to guide you through the process and advise you the best possible way to treat your anxiety.(6) It will take time to find out the right medication for you and the right treatment which will help you with your anxiety symptoms.  You can ask the doctor some questions related to your medications and ask them if using a medication is the right choice for you. 

References:

1. Anti-Anxiety Medications (Benzodiazepines) [Internet]. CAMH. [cited 2020 Nov 4]. Available from: https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/anti-anxiety-medications-benzodiazepines

2. Selective serotonin reuptake inhibitors (SSRIs) [Internet]. nhs.uk. 2017 [cited 2020 Nov 4]. Available from: https://www.nhs.uk/conditions/ssri-antidepressants/

3. Anxiety Medication – HelpGuide.org [Internet]. [cited 2020 Nov 4]. Available from: https://www.helpguide.org/articles/anxiety/anxiety-medication.htm

4. Anxiety medication: List, types, and side effects [Internet]. [cited 2020 Nov 4]. Available from: https://www.medicalnewstoday.com/articles/323666

5. Alternative Treatments for Anxiety Disorder [Internet]. Healthline. 2014 [cited 2020 Nov 4]. Available from: https://www.healthline.com/health/anxiety-alternative-treatments

6. Melinda. Anxiety Medication – HelpGuide.org [Internet]. https://www.helpguide.org. [cited 2020 Nov 4]. Available from: https://www.helpguide.org/articles/anxiety/anxiety-medication.htm

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