Exploring Anxiety Medications: Are All of Them Safe and Effective?

Anxiety is part of the body’s natural response to stress. Persistent anxiety that is not managed can turn into an anxiety disorder or another mental health condition. There are medical and non-medical solutions for managing anxiety. This article highlights the potential role that medications can play in effectively managing stress and anxiety.

How effective are drugs in treating anxiety disorder?

Temporary worry or fear is a normal part of everyday life. If you experience anxiety that does not go away, inhibits your ability to function normally, or becomes worse over time, consult your physician to determine if medication is the best treatment option for your situation.

Based on findings, certain medications can be very helpful in treating anxiety disorder. There is no cure for anxiety, but your physician may decide that medications should be used to help relieve symptoms. Some medications for anxiety, like benzodiazepines, may be addictive and can cause withdrawal symptoms when stopped suddenly.

How do I know which anxiety medications to take?

There are many prescription and non-prescription anxiety medications available. Keep in mind that only a medical professional can help you sort through the options to determine which drug is the best fit for you. It's important not to make such decisions independently.

Let’s discuss the differences between some of the currently available medications.

Prescription anxiety medications

Although there is no cure for anxiety, prescription medications may help manage persistent and worsening anxiety symptoms. Each medication has potential side effects, and some may be addictive when used long-term. It is important to seek expert advice to help you determine if your anxiety needs to be treated with medications, or if lifestyle modifications are sufficient.

Xanax

Xanax, or alprazolam, is a pharmaceutical drug commonly used for anxiety and panic disorders. Xanax, which is highly potent, belongs to a class of drugs called benzodiazepines and typically costs between $20 and $45 for 60 tablets in the United States without insurance coverage. It binds to GABA (gamma-aminobutyric acid-A) receptors in the brain and works by promoting calmness and relaxation.

Xanax side effects may include fatigue, dizziness, changes in sex drive, and confusion. It is effective in decreasing anxiety symptoms but can be highly addictive.

Xanax is short-acting and has a short elimination half life of 6-27 hours, which means it starts to work quickly and doesn't last in the body very long. It is usually prescribed to be used 3 times per day. Discontinuing Xanax use suddenly can commonly lead to more intense or rebound anxiety because of the short half life. If you are using Xanax, you should not stop using the drug abruptly without consulting your physician.

There are also other longer-acting benzodiazepines available.

Benzodiazepines

Other benzodiazepines used for anxiety include Ativan (lorazepam), Valium (diazepam), and Klonopin (clonazepam).

Benzodiazepines, regardless of half life, are generally prescribed for short-term use (<12 months) as needed to help with generalized anxiety disorder, panic disorder, and social anxiety disorder. They contain a black box warning, which is the most serious warning from the Food and Drug Administration. The warning states that even when used as prescribed, drugs in this class can lead to physical dependence and withdrawal when stopped suddenly. Benzodiazepines typically cost between $12 and $22 for 60 tablets in the United States without insurance.

Lorazepam is a potent, short-acting benzodiazepine that is less fat soluble than Xanax. This decreases the risk of lorazepam causing memory loss compared to Xanax. Lorazepam's use extends beyond anxiety to include alcohol withdrawal, and sedation and is typically prescribed to be used 3 times per day.

Diazepam is a long-acting benzodiazepine with medium potency. It lasts longer in the body with increased age over 40. The long half-life can cause diazepam to build up in the system, especially in the elderly, leading to over sedation and additional side effects. Diazepam dosing varies based on the patient's age, but is typically prescribed to be used 2 to 4 times per day.

Clonazepam is a potent, long-acting benzodiazepine that also increases the neurotransmitter serotonin to improve mood. For panic and anxiety disorders, clonazepam is typically prescribed to be used 2 times per day.

If you have been using any benzodiazepine longer than two months, you should consult your healthcare provider before stopping the drug. Benzodiazepine withdrawal is dangerous and long-term use may cause seizures, decreased blood pressure, and trouble sleeping.

Benzodiazepine side effects may include fatigue and tiredness, confusion, and dizziness. They can also cause problems with coordination and difficulty speaking.

Buspirone

Buspar (buspirone) is prescribed as another short-term anxiety medication. It belongs to a class of drugs called anxiolytics and typically costs between $13 and $20 for 60 tablets in the United States without insurance. It works by balancing levels of neurotransmitters, such as serotonin and GABA, in the brain leading to mood regulation.

Buspirone is usually taken twice daily and may take a few weeks to feel effects. Your physician may start you on a low dose and increase your dose over time until you reach a dose that works for you. Side effects may include dizziness, diarrhea, headache, and confusion.

Antidepressants

Antidepressants used for anxiety include SSRIs, MAOIs, and tricyclic antidepressants.

  • Selective serotonin reuptake inhibitors (SSRIs). SSRIs like Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), and Lexapro (escitalopram) are used to treat panic disorders. Fluoxetine, for example, costs $12–15 for 30 capsules, blocking serotonin reabsorption to improve mood. SSRIs may take weeks to work, with potential side effects like sleep issues, nausea, nervousness, and diarrhea.
  • Tricyclic antidepressants. Tricyclic antidepressants such as clomipramine target OCD, costing $25–28 for 30 capsules in the U.S. They reduce serotonin reabsorption, showing OCD benefits in 6–12 weeks, with immediate anxiety relief. Side effects may include nausea, increased appetite, and blurred vision, and dizziness.
  • Monoamine oxidase inhibitors (MAOIs). MAOIs like isocarboxazid and phenelzine, also for panic disorders, cost $45–310 for 60 tablets. They increase neurotransmitter levels to enhance mood but are prescribed only when absolutely necessary because of food and drug interactions and safety concerns. If you are prescribed MAOIs, it is critical that you alter your diet accordingly. Benefits take 2–3 weeks to appear, with side effects like constipation, trouble sleeping, and dry mouth, as well as food interactions leading to blood pressure spikes.

Beta-blockers

Beta-blockers are usually used to manage blood pressure and heart conditions. They work by slowing down the heart rate. Propranolol, for instance, is a beta-blocker that typically costs between $9 and $12 for 30 tablets and is used off-label to treat the physical symptoms of social anxiety, such as shaking and rapid heartbeat during times of stress.

Beta-blockers are usually prescribed to be used for social anxiety symptoms as needed, often taken only before a major speech or performance. Propranolol typically starts to work in a few hours.

Side effects may include tiredness, dizziness, and diarrhea.

Over-the-counter anxiety medications

There are some natural non-prescription supplements that may help with mood, stress, and anxiety. Although these supplements are available over the counter, you should still consult your physician before using them to ensure they don't interact with other medications or supplements you may be using. Three specific supplements that have been shown to relieve stress are L-theanine, ashwagandha, and chamomile.

L-theanine, a natural amino acid found in green tea, offers stress relief, improved sleep, and mood regulation. Similarly, ashwagandha, an adaptogenic herb, aids in stress reduction and anxiety management.

Additionally, chamomile supplements or tea consumption have been shown to induce relaxation and alleviate anxiety symptoms, as evidenced by a 2016 study that found reduced anxiety levels and blood pressure in patients with generalized anxiety disorder who consumed chamomile capsules.

Alternative therapies to treat anxiety

Lifestyle changes are also effective remedies for supporting stress. These changes are easy to incorporate and do not require a prescription. Exercise and mindful meditation are two lifestyle changes that have been studied as alternative therapies of anxiety.

Regular physical activity is known to alleviate stress by building resilience against its emotional impacts and guarding against stress-related illnesses. Participating in regular exercise releases mood-boosting neurotransmitters, serotonin, and dopamine, in the brain. Exercise has positive effects in helping manage anxiety and depression in otherwise healthy individuals and those with chronic illnesses like obesity and diabetes.

Meanwhile, mindful meditation is being investigated as a readily available and cost-effective treatment for anxiety, highlighting its potential as a valuable tool in stress management. One study observed the impact of a daily, 6-week online Isha Kriya meditation program on depression and anxiety symptoms in 259 patients. The study results showed significant improvements in depression and anxiety symptoms after 2 weeks.

Side effects of anxiety medications

Side effects of anxiety medications range from dizziness and fatigue to confusion and trouble sleeping. If you are currently taking anxiety medications and experience undesirable side effects that inhibit your ability to complete normal tasks, consult your healthcare provider. Do not stop taking the drug abruptly. Your doctor will guide you on stopping, replacing, or adjusting your medication dose to safely manage your health.

Persistent worry and fear that disrupt your normal functioning may indicate the need for medical intervention. In such cases, consulting a healthcare provider is also advisable to explore prescription, non-prescription, and alternative methods for managing anxiety. While prescription medications can be effective for short-term relief, they come with potential side effects and risks of dependency.

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Comments

liana
prefix 1 year ago
thanks for info