Individuals experience anxiety in many ways and are often prescribed anxiety medications to alleviate their symptoms. Before considering the classes of medication and how they are used in specific anxiety disorder treatments, it’s helpful to consider the wide range of common anxiety conditions that meet the medical criteria for anxiety disorders.
- Panic disorder describes persistent panic attacks, or periods of acute fear and terror with distressing physical sensations.
- Agoraphobia refers to the fear of having a panic attack in a place where escape is not possible and help is not available.
- Specific phobia encompasses fear of certain things or places such as: animals; thunder; blood; flying, bridges, or tunnels; or other definite fears.
- Social phobia describes fear of social situations such as talking to authority figures or dating.
- Post-traumatic stress disorder (PTSD) is caused by experiencing a traumatic event.
- Obsessive compulsive disorder (OCD) describes persistent and unwelcome thoughts along with compulsive actions.
- Generalized anxiety disorder (GAD) refers to ongoing, persistent fear and worry that permeates many areas of life.
There is widespread agreement that many anxiety disorders have a psychological basis and are, therefore, not appropriate for pharmaceutical treatment alone. However, with ongoing brain research, scientists are finding neurochemical brain changes in anxiety disorders, and psycho-pharmaceutical medications can effectively treat a wide range of anxiety syndromes.
Classes Of Anti-Anxiety Medications
- Atypical Benzodiazepines
- Beta Blockers
Benzodiazepines produce a calming effect in many areas of the brain and a sedating physical effect. The brain has natural although complex mechanisms to reduce fear and overall brain excitation, and they assist in that process by attaching to one of three benzodiazepine receptors in the brain’s nerve cells. Because nerve cells in the brain carry benzodiazepine receptor molecules, researchers believe that individuals who experience anxiety may be deficient is an undiscovered naturally occurring brain chemical that produces feelings of calm.
Benzodiazepines can lead to dependence and potential abuse. While many people safety take benzodiazepines, over the long term, they are not indicated for those with a family or personal history of substance abuse. Benzodiazepines brand names include: Valium, Librium, Centrax, Tranxene, Klonopin, Ativan, Xanax, Serax, Halcion, Versed and Dalmane.
BuSpar (buspirone) is an atypical anti-anxiety medication that does not lead to dependence. Its mechanism is not fully understood, but it reduces anxiety, rumination and worry without the sedating qualities of the benzodiazepines. It is often used for individuals with generalized anxiety disorder (GAD).
Atarax and Vistrail reduce anxiety by blocking histamine receptors in the central nervous system, causing sedation and relaxation. They are not habit forming but a tolerance to these drugs can develop over time.
Inderal and Tenormin effectively reduce the physical symptoms of anxiety, especially rapid heart rate, but are not effective at stopping or diminishing the thoughts that pervade anxiety.
Classes of Antidepressant Medications
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Serotonin And Norepinephrine Reuptake Inhibitors (SNRIs)
- Monoamine Oxidase Inhibitors (MAOs)
- Tricyclic Antidepressants.
Serotonin is a chemical believed to regulate mood and anxiety. SSRI antidepressants are useful in treating obsessive compulsive disorder (OCD), even if the individual does not experience depression. SSRI antidepressants selectively increase serotonin activity in several areas of the brain, and antidepressants that do not affect serotonin are not efficacious in relieving OCD symptoms. The SSRI pharmaceuticals used for treating OCD are considered anti-obsessional medications and include: Anafranil, Prozac, Zoloft, Paxil, Luvox, Celexa and Lexapro. The SSRI class of medications can have negative side effects, including impaired sleep and anxiety.
While selective serotonin reuptake inhibitors (SSRIs) are used for OCD, the SNRI class of medication appears to be most promising for other anxiety syndromes. Effexor, an SNRI medication, was the first antidepressant to get approval for use in treating generalized anxiety disorder (GAD), social anxiety disorder and panic disorder in adults. SNRI medications block the reuptake of neurotransmitters serotonin and norepinephrine, making these neurochemicals more available to the brain, and increase chemical activity. There is speculation that serotonin can reduce the cellular activity in the amygdala, the primitive area of the brain’s limbic system that controls fear and the fight/flight/freeze response. Cymbalta also acts on both serotonin and norepinephrine and is approved for treatment of GAD. Remeron is sometimes used for treatment of post-traumatic stress disorder and social anxiety disorder.
MOA inhibitors (Monoamine Oxidase Inhibitors) are a group of antidepressants that are used for panic disorder and social phobias. Social phobias are linked to hyperactivity in the limbic area of the brain. In theory, this may be the area of the brain designed trigger arousal and distress behavior (usually vocal) when infants are separated from their caregivers. Because MAO inhibitors are effective for this disorder, researchers believe that social phobias may stem from a low level but chronic arousal of the biological infant protection mechanism. MOA inhibitors may produce serious side effects and are prescribed with caution.
Tricyclics are older antidepressants that carry frequent side effects. Because of that, they are only prescribed if SSRI medications have not helped. The tricyclic antidepressants include Tofranil, Pamelor, Norpramin and Anafranil.
Only take prescription medication under a doctor's supervision. Side effects and changes should be tracked and monitored since dosage or type can be altered. Also, before stopping medication, always alert a doctor as oftentimes a gradual weaning phase is recommended.