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.
Antidepressants For Anxiety: What Medication Options Exist
Medically reviewed by Kristin Hall, FNP
If youve been diagnosed with an anxiety disorder, your healthcare provider may recommend one of several medications, including anti-anxiety medications, beta-blockers and, for certain types of anxiety, antidepressants.
Although antidepressants are typically viewed as treatments for depression, several modern antidepressants are approved to treat anxiety disorders such as generalized anxiety disorder and panic disorder.
Below, weve explained how antidepressants may help to treat anxiety, as well as the specific antidepressants your healthcare provider may prescribe if you have an anxiety disorder.
Weve also discussed how long it usually takes for anxiety to improve, the side effects you may experience while using antidepressants to treat anxiety and more.
An Overview Of Practice
A stepped-care model for the management of anxiety is recommended. Australian2 and UK3 guidelines list non-drug approaches as initial interventions. They include individual non-guided or guided self-help, and psychoeducational groups. For patients who present with marked functional impairment and those who do not respond to the initial interventions, high-intensity psychological interventions or medication are recommended.
Australasian guidelines for panic and agoraphobia4 identify cognitive behavioural therapy as first-line treatment. As a sole therapy, it can be at least as effective as pharmacotherapy and in some cases more so. Antidepressants alone are less effective than cognitive behavioural therapy alone, or the combination of an antidepressant and cognitive behavioural therapy.4-6 Additionally, cognitive behavioural therapy is more likely to give lasting benefit. In contrast to depression, efficacy appears to be lost soon after stopping antidepressants, with a recurrence of anxiety being the rule rather than the exception.
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How K Health Can Help
Anxiety and depression are among the most under-reported and under-treated diseases in America. Nearly 20% of adults in the U.S. suffer from mental health illness with fewer than half receive treatment. Our mission is to increase access to treatment for those suffering in silence.
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Other Medications For Anxiety
Many other medicines may help treat anxiety, although doctors usually only prescribe them if SSRIs or similar drugs do not work.
Other medications for anxiety include:
Beta-blockers
Beta-blockers are a common medication for people with high blood pressure and heart conditions. However, doctors may prescribe them off-label for anxiety in certain situations.
Beta-blockers reduce the effects of norepinephrine, meaning that they can relieve some of the physical symptoms of anxiety. Examples of beta-blockers include atenolol and propranolol .
Buspirone
This anti-anxiety medication may treat short- or long-term anxiety symptoms.
Buspirone works much more slowly than benzodiazepines and may not treat all types of anxiety disorder, but it causes fewer side effects and has a lower risk of dependency.
Monoamine oxidase inhibitors
Monoamine oxidase inhibitors are one of the earliest types of antidepressant. Doctors may prescribe them off-label to treat the symptoms of panic disorder and social phobia. Types of MAOI include:
- isocarboxazid
- sweating
- weight gain
These medications also interact with several other drugs as well as some foods and drinks. Anyone taking MAOIs should ask their doctor for a complete list of the medicines, foods, and drinks that they need to avoid.
The United States Food and Drug Administration require all antidepressants to carry a black-box warning relating to the risk of suicide in children and young adults.
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Combining Psychotherapy And Medication
Both psychotherapy and pharmacotherapy have been shown to be more effective than control groups. However, whereas drugs are mostly compared with placebo controls, the evidence for psychotherapy in anxiety disorders is mainly based on comparisons with a wait-list, a control method that was used in 70% to 75% of the studies in adults and children.,, Because pill placebos have higher effect sizes than waitlist controls, the effect size differences between active and control conditions cannot be compared between psychotherapy and medication studies. Therefore, our research group conducted a large meta-analysis of all available controlled short-term studies for anxiety disorders and compared the pre-post effect size differences between medications and psychotherapies. In this meta-analysis, which was based on studies with around 35 000 patients, medications were associated with a significantly higher average pre-post effect size than psychotherapies . It was also found that patients included in psychotherapy studies were less severely ill than those recruited for medication trials.
The meta-analysis also showed that combinations of psychotherapy and pharmacotherapy had a relatively high effect size . However, only a few combination studies were available for this comparison, and some of these have not been conducted with the most powerful drugs.
Which Benzodiazepines Are Used For Anxiety
They can also be used with antidepressants initially while antidepressants take time to work.
“They’re a powerful tool,” says Duckworth, “but you have to be really smart about their use.”
- Light-headedness
- Trouble sleeping
Beta-blockers can be very helpful but in a limited way, says Dr. Salcedo. They are most commonly used for performance anxiety. They are really good for the physical symptoms such as heart racing, sweating, shakiness, but they work less well for the anxious thoughts that might be causing the symptoms.
Additional reporting by Carlene Bauer.
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Treatment Of Gad In Older Patients
With the exception of GAD, anxiety disorders are less common in patients over 65 years of age. Therefore, only a few studies for the treatment of GAD have been performed with older patients. Controlled studies have shown the efficacy of duloxetine, venlafaxine, pregabalin, and quetiapine in patients over 65 years old. In the elderly, an increased sensitivity to drug side effects and interactions must be considered, including anticholinergic effects, risk of orthostatic hypotension and cardiovascular events, risk of falling, and paradoxical reactions to benzodiazepines.
In the elderly, effect sizes for CBT tend to be somewhat smaller than those found in mixed-age populations. A meta-analysis of studies with older adults with GAD showed superiority of CBT to waitlist or treatment-as-usual conditions but not to active controls .
Other Common Anxiety Medications That Can Be Addictive
Ativan is a benzodiazepine and it works by attaching to GABA receptors in the brain. Ativan is highly addictive so doctors usually only prescribe it for short-term use spanning 3 to 4 months. However, many people become physically dependent and abuse it. Heavy abuse of lorazepam or using lorazepam with alcohol or other drugs can cause insomnia, headaches, weakness, memory problems, anorexia, and anxiety. Quitting Ativan abruptly can also cause withdrawal symptoms such as depression, confusion, short-term memory loss, sweating, hallucinations, anxiety, delirium, and vertigo.
Librium is another habit-forming psychotropic drug that is used to treat anxiety. Misusing Librium in any way can lead to dependence, withdrawal symptoms, and addiction. Its a Schedule IV regulated drug and directly affects the brain and central nervous system to produce feelings of calmness and relaxation. People who misuse Librium often snort the contents of the capsules or mix the powder with water and inject it. Some people also use it to curb the side effects of powerful and illegal drugs like cocaine.
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Why Is This Medication Prescribed
Escitalopram is used to treat depression in adults and children and teenagers 12 years of ago or older. Escitalopram is also used to treat generalized anxiety disorder in adults. Escitalopram is in a class of antidepressants called selective serotonin reuptake inhibitors . It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.
Pharmacotherapy Of Anxiety Disorders: Current And Emerging Treatment Options
- 1Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- 2Silver Hill Hospital, New Canaan, CT, United States
- 3Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- 4Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- 5Department of Psychiatry and Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- 6Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- 7Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
- 8Department of Psychiatry, New York University School of Medicine, New York, NY, United States
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Talking To Your Doctor
It is important to communicate regularly with your doctor when you are anxiety medications, especially if you are prescribed any other medications. Keep track of your symptoms so that they can find the best medication for you, and also keep track of any side effects you experience. If you are having trouble finding a medication that works, drug-genetic testing can help your doctor determine appropriate options. If you become pregnant or are breastfeeding, be sure to ask what medication is safest.
Some anxiety medications carry warnings that they may increase suicidal thoughts, particularly among young people. Be sure to communicate with your doctor if you experience any suicidal thoughts while on the medication or monitor your child if they are taking them. Also, if you are taking any anxiety medications that have habit-forming potential, be sure to talk to your doctor if you feel that you are becoming dependent on the medication or have a history of substance abuse.
Above all, its important to not get discouraged if an anxiety medication isnt the right fit for you. With patience, observation, and communication, you and your doctor can find the medication that best fits your symptoms and needs.
List Of Anxiety Medications Antianxiety Medications List
A list of anxiety medications includes several types of medication including antidepressants, antipsychotics, beta blockers, and benzodiazepines. The anti-anxiety medication list below includes all drugs approved by the FDA for the treatment of anxiety disorders as well as those commonly prescribed off-label.1
Only one drug is of the anti-anxiety medication class: Buspirone . This drug is approved for anxiety disorders .
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Can You Get Hooked On Anxiety Medication
Yes, anxiety medication can be highly addictive. Consistent use of anti-anxiety drugs can quickly cause physical dependence and withdrawal symptoms. Many people mistake withdrawal symptoms for a return of their anxiety, leading them to believe that they need to take more of the medication or begin using it again after their prescription has run out. Taking anti-anxiety drugs for long periods or taking more of the drugs than directed is likely to cause addiction.
Which Treatment Is Most Suitable
When deciding whether to have psychological treatment or use medication, your personal preference and individual needs will play a big role. The right kind of psychological treatment can be very effective and help you to overcome your anxiety. But it takes a lot of motivation and determination, and you often have to wait a long time to get an appointment. Depending on a persons individual situation and the severity of their disorder, it might therefore be a good idea to start taking medication first. Sometimes it isn’t really possible to begin psychological therapy until medication has been used to at least partially relieve the symptoms.
Some people don’t want to start taking antidepressants because they are afraid they might end up becoming dependent on them. But unlike some painkillers, sedatives and sleeping pills antidepressants do not lead to dependency. Others see taking tablets to cope with their problems as a sign of weakness. But there’s no reason to feel ashamed of taking medication to treat a mental illness. Medicine can be helpful, and in some cases even necessary, when trying to overcome anxiety.
Regardless of what decision you make, there are medications and psychological treatments that can help you cope with generalized anxiety disorder and start living a normal life again.
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Can I Have Depression And Anxiety At The Same Time
Depression and anxiety are two different mental health disorders that are often comorbid. Meaning, they occur at the same time.
Depression is a mental disorder that is commonly identified with intense feelings of hopelessness, despair, worthlessness, and overwhelming sadness. Around 10% of Americans experience major depression , according to theCleveland Clinic. While most people will experience feelings of sadness at some point, with depression, these feelings are prolongedlasting two weeks or moreand severe enough to impact daily life.
Anxiety disorders are characterized by excessive worry, nervousness, or fear that impacts everyday functioning. Without treatment, anxiety can get worse over time. There are a number of anxiety disorders, with their own set of unique symptoms.
About 2% of people in the U.S. have generalized anxiety disorder . According to Richard Shelton, MD, a psychiatrist and the vice chair of research at the University of Alabama at Birmingham, GAD symptoms include persistent fear and worry that is often difficult to control. Other anxiety disorders include:
- Panic disorder
- Posttraumatic stress disorder
Depression and anxiety have the following symptoms in common: feelings of despair like nothing good will ever happen, physical symptoms , and exhaustion.
Antidepressants For Anxiety: The Basics
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Some antidepressants may help to improve the way your brain uses chemicals that control stress and mood, reducing feelings of anxiety.
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Not all antidepressants are approved to treat anxiety. When an antidepressant is used to treat an anxiety disorder, its generally a selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor .
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Older antidepressants such as tricyclic antidepressants and monoamine oxidase inhibitors are less commonly used as first-line treatments for anxiety.
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Antidepressants can take several weeks to start working, meaning its important to keep using them even if you dont notice an immediate improvement in your feelings, anxiety levels and general mood.
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If youve been diagnosed with an anxiety disorder, your healthcare provider may suggest undergoing psychotherapy in addition to using medication.
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Antidepressants can be extremely helpful, but they can also have drawbacks. You might experience side effects while using antidepressants, or need to try several medications before finding one thats a good fit for you.
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If youre prescribed an antidepressant to treat anxiety, dont change your dosage or stop taking it without first talking to your healthcare provider. .
Stopping antidepressants suddenly can cause antidepressant discontinuation syndrome and withdrawal symptoms.
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