Ssris And Benzodiazepines For General Anxiety Disorders
Feeling anxious, worried, and tense? You are not alone! Anxiety disorders are the most common mental illness in the US, and General Anxiety Disorder affects 6.8 million adults every year . When feeling overwhelmed with worries and tension, the first step many people take is to ask their doctors about medication. If you struggle with GAD, and are thinking about starting medication, here is some information about two of the most commonly prescribed types of medication: SSRIs and benzodiazepines.
Selective Serotonin Reuptake Inhibitors include medications such as Zoloft , Prozac , Celexa , and Lexapro . These medications work on serotonin, an important neurotransmitter that plays a role in feelings of well-being and happiness, as well as thinking, memory, sleep, digestion, and circulation. SSRIs are currently considered the first-line medication for many forms of anxiety. If you are considering starting an SSRI, here are some important things to consider:
Benzodiazepines include medications such as Xanax , Ativan , and Valium . These medications strengthen the effect of the neurotransmitter GABA, which is the primary inhibitory signaler in the brain. GABA plays a role in sleep, feeling calm, muscle relaxation, and reduction in brain activity. If you are considering starting a benzodiazepine, here are some important things to consider:
Regardless of who you are or your thoughts on these medications, here are some essential things to know and do when taking medication:
Are There Differences Among Anxiety Medications
Anxiety medications in the same drug class work in a similar way and there are similarities between classes of anxiety medications.
- The SSRIs affect brain serotonin levels. They are the first-line for treating most types of anxiety.
- Other antidepressants, including the tricyclics and the monoamine oxidase inhibitors , that also act on brain serotonin and norepinephrine levels have more limited use because of their side effects and drug interactions.
The anxiolytic drugs, which specifically target these disorders, work in different ways and have specific treatment applications.
- Benzodiazepines act on the neurotransmitter gamma aminobutyric acid .
- Buspirone enhances the activity of serotonin.
- The antihistamine hydroxyzine , has a sedative effect by blocking certain receptors in the brain.
Medications normally used to treat high blood pressure also have specific off-label uses for treating panic disorders.
- The beta-blockers propranolol and atenolol have become a popular remedies for performance anxiety, also known as stage fright. They may also have some use in PTSD.
- The alpha-blocker prazosin eases nightmares from PTSD.
- Other alpha-blockers, such as clonidine and guanfacine , may also be useful for treating PTSD.
What If An Antidepressant Doesnt Work
If you donât notice any change in your mood after a few weeks, talk with your doctor. If the first antidepressant you take doesnât work, itâs likely that another one will. About 60% of people who take antidepressants feel better with the first medicine they take, but others need to try more than one before noticing a change.
A study funded by the National Institute of Mental Health in 2008 found that about 50% of patients who did not feel better after using one medication noticed an improvement when they took a new one or added a second medication to the first treatment. You and your doctor can work together to find the medication thatâs right for you.
âI had to try a couple of different kinds of medications to find the right one for me,â Brennan tells WebMD. âOne medication worked for a little while, and then I started to feel depressed again. So my doctor switched me to another medication, and that one is working great. Itâs just a matter of sticking with it and letting your doctor know how youâre feeling.â
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What Medications Are Used To Treat Anxiety Disorders
When treating anxiety disorders, antidepressants, particularly the SSRIs and some SNRIs ,Ã Ã have been shown to be effective.
Other anti-anxiety drugs include the benzodiazepines, such as as alprazolam , diazepamÃ , buspirone ,Ã and lorazepam . These drugs do carry a risk of addiction or tolerance , so they are not as desirable for long-term use. Other possible side effects include drowsiness, poor concentration, and irritability. Some anticonvulsant drugs , some blood pressure medications , and some atypical antipsychotics are also occasionally used “off label” to treat anxiety symptoms or disorders.
How Ssris Are Used To Treat Social Anxiety Disorder
Selective serotonin reuptake inhibitors are usually the first choice of medication for treating social anxiety disorder . SSRIs affect your brain chemistry by slowing re-absorption of the neurotransmitter serotonin, a chemical that we think helps to regulate mood and anxiety.
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Other Medications Used To Treat Anxiety
In addition to antidepressants, several other types of medications are used as treatments for anxiety disorders. Other medications used to treat anxiety include:
Benzodiazepines.Benzodiazepines such as alprazolam , diazepam and lorazepam are often used to treat generalized anxiety disorder and several other anxiety disorders.Benzodiazepines have both advantages and disadvantages as anxiety treatments. While theyre usually effective and begin working quickly, people treated with benzodiazepines can quickly develop a tolerance and, in some cases, become dependent on them.
Buspirone.Buspirone is a non-benzodiazepine medication thats used to treat anxiety disorders, particularly generalized anxiety disorder . Its often used when SSRIs arent effective or produce unpleasant side effects.Buspirone can take several weeks to start working effectively. Unlike benzodiazepines, theres no risk of dependence or withdrawal in people treated for anxiety disorders with buspirone.
Beta-blockers. Beta-blockers, which are commonly used to treat hypertension , are also used to treat the physical symptoms of anxiety.Beta-blockers start working quickly and are effective for controlling shaking, trembling, rapid heartbeat and other physical anxiety symptoms for short periods, such as during an event, performance or other anxiety-producing situation.
What Does This Tell Us All In The End It Tells Us That We Must Fix The Cause Of The Problem Not Try To Manage The Problem Itself With Antidepressants And Anxiety Medications
*Please understand that this post on antidepressants and anxiety medications was solely my opinion on the subject. I want too hear what you have to say! Please comment below in the comment section.
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Mindfulness And Applied Relaxation
Mindfulness and applied relaxation are alternative types of psychological treatment.
Mindfulness focuses your awareness on the present moment. It allows you to acknowledge and accept certain feelings. It can reduce anxiety associated with the fear of actual situations or sensations. It helps to counter the sense of ‘tunnel vision’ that may develop during anxiety.
Applied relaxation focuses on relaxing your muscles in a particular way. A trained therapist teaches the technique which alleviates anxiety and involves:
- learning how to relax your muscles
- relaxing your muscles quickly in response to a trigger
- practising relaxing your muscles in situations that make you anxious
Can Antidepressants Cause Anxiety
Dr. Shelton says that SSRIs typically dont cause anxiety symptoms. However, if a patient is very anxious its a good idea to start on a very low dose to allow the patient to adjust to the medication slowly.
Dr. Plummer says that a patient starting an SSRI may notice an initial increase in anxiety. It takes a minimum of two to four weeks, sometimes longer, for SSRIs to reach the serotonin levels needed to relieve the depression or anxiety, she says.
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Are Antidepressants Safe
Antidepressants are generally safe. However, most antidepressants used for menopause symptoms are considered off-label use. This means that antidepressant manufacturers havent conducted the same rigorous trials to ensure safety and effectiveness when it comes to treating hot flashes and night sweats.
Theres one medication called Brisdelle thats been studied by the U.S. Food and Drug Administration specifically to treat vasomotor symptoms. Its been shown effective in reducing hot flashes and night sweats during menopause.
Antidepressants can also interact with other medications, so make sure to tell your doctor about all over-the-counter and prescription medication you take. This includes vitamins and supplements as well.
You should also tell your doctor if you have:
- high cholesterol
Your doctor can help you weigh the benefits and risks of using antidepressants for menopause symptoms.
They Are Not Addictive
Antidepressants, like most medications, can change the way you feel. This means that if you stop taking the medication you may start to feel the way you did before the treatment. Some people confuse this with being addicted. Antidepressants are not addictive and you will not become dependent on them. However, it is important to talk to your doctor before you stop taking them. It is always advisable to reduce the dose slowly, with close monitoring, to minimise possible discomfort as your body adjusts to the lower dose. It is also important that the medication is monitored carefully in the first couple of months, as some people may experience an increase in symptoms if the antidepressant is not effective.
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Special Benzodiazepine Risk Factors
Anyone who takes benzodiazepines can experience unpleasant or dangerous side effects. But certain individuals are at a higher risk:
People over 65. Older adults are more sensitive to the sedating effects of benzodiazepines. Even small doses can cause confusion, amnesia, loss of balance, and cognitive impairment that looks like dementia. Benzodiazepine use in the elderly is associated with an increased risk of falls, broken hips and legs, and car accidents. Long-term benzodiazepine use also increases the risk of Alzheimers disease and dementia.
People with a history of substance abuse. Because theyre physically addicting and on their own and dangerous when combined with alcohol and other drugs, anyone with a current or former substance abuse problem should use benzodiazepines only with extreme caution.
Pregnant and breastfeeding women. Benzodiazepine use during pregnancy can lead to dependence in the developing baby, with withdrawal following birth. Benzodiazepines are also excreted in breast milk. Therefore, pregnant women need to have a thorough discussion about the risks and benefits of these medications with their prescribing doctor. If medication is necessary, the goal is the smallest effective dose.
The connection between benzodiazepines and accidents
What Can You Do Yourself
Many people with generalized anxiety disorder don’t even think of going to see a doctor. They try to manage their fears on their own, for example using books or information from the internet. Some learn relaxation techniques, such as progressive muscle relaxation, autogenic training or yoga. The effectiveness of these kinds of strategies for managing anxiety disorders on your own is not well studied in scientific studies. Relaxation techniques are often used in psychological treatments, but it isn’t known how effective they are when used alone.
Some people try herbal sedatives like valerian, lavender or passion flower. There hasn’t been much research on these products either. Many people assume that herbal remedies are better tolerated and safer than other kinds of medicine. But they can also have side effects and may influence the effects of other medication.
People who treat an anxiety disorder on their own may only seek professional help after a very long time. If an anxiety disorder is really affecting your everyday life, certain kinds of psychological treatment and medication can help.
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If You Experience Depression
If you experience depression, you may:
- feel very down a lot of the time
- no longer enjoy the things you usually enjoy
- find it hard to talk to people about how you feel
- find it hard to look after yourself and carry out day-to-day tasks
- self-harm or experience suicidal feelings, especially if you have severe depression.
Taking antidepressants may help to lift your mood. This can help you feel more able to do things that dont feel possible while youre depressed. This may include using other types of support for your mental health. See our page on treatments for depression to find other options which may help.
If you feel unable to keep yourself safe, it’s a mental health emergency.
The National Institute for Health and Care Excellence produces guidelines on best practice in healthcare. This includes guidelines for prescribing antidepressants for people with different levels of depression. These guidelines suggest the following:
When To See A Doctor
If your depression symptoms return for more than a few days, it’s time to see your doctor. But even if you feel like your antidepressant isn’t working, it’s important to keep taking it until your doctor advises otherwise. You may need a dosage increase or a slow tapering off process. With many antidepressant medications, stopping their use too quickly can cause withdrawal effects such as:
- Greater anxiety
- Suicidal thoughts
Early warning signs of breakthrough depression are the symptoms you typically experience when an episode of depression is coming on, says Nestadt. Depression symptoms vary from person to person, but signs include:
- Low mood
- Changes in sleep or appetite
- Loss of interest in previously enjoyable activities
If your symptoms return, don’t worry adjusting the dose or switching to another antidepressant often solves the problem.
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What Are Ssris And Snris
Selective serotonin reuptake inhibitors like Zoloft and Prozac, and serotonin and norepinephrine reuptake inhibitors like Effexor and Pristiq are antidepressant medications, but they can help with anxiety symptoms as well. For this reason, many providers will prescribe an SSRI or SNRI if you have a combination of depression and anxiety.
SSRIs and SNRIs are not an instant fix for symptoms associated with an anxiety disorder, nor do they even provide immediate relief, Alonzo said. They work by interacting with the neurotransmitters and receptors in your brain, which can help regulate mood, sleep and energy levels. It is important for patients to understand that these medications may take four to six weeks for full effect.
Some patients may respond better to one of these medications than others. If after taking the medication for two weeks and symptoms have not improved, talk to your provider to have your medication regimen adjusted. Treatment trials with more than one medication are not uncommon.
What Are Anxiety Disorders
Anxiety disorders affect 31.9 percent of people between the ages of 13 and 18, and women are twice as likely to develop an anxiety disorder as men. Common examples of anxiety disorders include generalized anxiety disorder, panic disorder, social anxiety disorder, substance-induced anxiety disorder and specific phobias.
An anxiety disorder does more than make you anxious. They can affect your entire life. Plus, untreated anxiety can lead to other mental health disorders and physical conditions, Alonzo said. We have no way of predicting what will cause someone to develop an anxiety disorder. However, you can take steps to reduce the impact of symptoms such as getting help from a health care professional early and avoiding the use of non-prescribed drugs and alcohol.
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Antidepressants For Anxiety Disorders
Anxiety is defined as an unpleasant feeling of nervousness or fear that is often accompanied by unrealistic thinking, dread, and panic. For some individuals, anxiety is an uncontrollable part of life no matter what they do, they cannot escape the anxious thoughts, constant worry, and physical symptoms such as a fast heart rate. If left untreated, anxiety can become so extreme that a person can becomes afraid to leave the house, form social bonds, and hold down a job.
In the event that a person fails to adequately treat their anxiety, it may lead to a nervous breakdown and/or social isolation. Fortunately there are many effective treatment options for anxiety sufferers. Although many doctors will recommend natural treatment options such as cognitive behavioral therapy , meditation, and physical exercise antidepressants are considered first-line treatments.
For Some People Relief From Stress And Anxiety Can Be Helped Considerably With Medication While A Prescription To An Anxiety Medication Isnt A Cure
The exact type of medication for anxiety and stress depends largely on how it is to be used in your recovery.
The exact type of medication for anxiety and stress depends largely on how it is to be used in your recovery. Some anxiety medications work by making your body relax so that your mind will follow. These are useful for providing rapid relief during a period of intense anxiety but are not beneficial, and may even make things worse if used long-term.
Most often, drugs used for short-term relief of anxiety are members of the benzodiazepine class of drugs, which includes diazepam , alprazolam , and lorazepam .
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How Antidepressants Work With Ibs
Although medications in this class are called antidepressants, they have effects that go beyond stabilizing a depressed mood.
Antidepressants have been shown to reduce anxiety and pain sensations while having positive effects on the digestive system. It’s even becoming common for these drugs to be called neuromodulators, which target the nervous system, rather than antidepressants.
Specifically, antidepressants have been found to have a positive effect on:
Experts believe these benefits are from the medications acting on neurotransmitters found in the brain and the gut. These neurotransmitters are chemical messengers that help nerve cells communicate with each other. They include acetylcholine, serotonin, norepinephrine, and dopamine.
Healthcare providers may prescribe an antidepressant to someone with IBS. This is considered an “off-label” use of the drug. No antidepressant has been approved by the U.S. Food and Drug Administration as an IBS treatment.
However, the ACG, after an extensive research review, concluded that research is strong enough for them to recommend tricyclic antidepressants for IBS. The organization no longer recommends the use of selective serotonin reuptake inhibitors , but these drugs are still commonly used for IBS.