Anxiety Disorders and Medication

Many people don't realize that most anxiety disorders have at least some biological component and often respond to medications. Medications have proven extremely effective in eliminating or reducing many of the symptoms of an anxiety disorder and helping the patient regain control or his or her life.

Taken under a doctor's supervision, medications can play a valuable role in overcoming panic disorder, phobias and other anxiety disorders, such as obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD).

Medication is most effective when combined with psychological therapies. The chance of recurrence is reduced when medication and psychological therapies are used together.

Finding the right medication and dosage for each individual may require some detective work on the part of the physician. Diagnosing the specific disorder will narrow the field of appropriate medications, and the doctor will make the final selection based on individual circumstances and the patient's health history.

Side Effects and Other Reactions

Knowing what to expect prevents unnecessary concern and also alerts the patient to the kinds of reactions that should be reported right away. Most people can take medications commonly used to treat anxiety disorders without difficulty, but sometimes there are side effects. Side effects vary with the drug, but they can range from minor annoyances like dry mouth or drowsiness to more troubling reactions like an irregular heartbeat. Fortunately, most side effects disappear in the first week or two of treatment.

If the side effects persist, or if they interfere with normal activities, ask the doctor if he or she would change dosages or try a different medication.

Using medication is more complicated for some groups of people. The doctor should be informed if a woman is pregnant or attempting pregnancy.

Young children and the elderly also need special attention. Treatment of elderly patients may be complicated by other health problems and/or other medication regimens. Two other sections within the ADAA web-site, "Anxiety Disorders and Children and Adolescents" and "Helping a Family Member," have more information on these topics.

People with high blood pressure, kidney and liver ailments, or other chronic conditions may need to avoid certain medications.

Patients should not deviate from the prescribed medication dosages unless instructed by their doctor. Getting the right results from medication depends on taking the right amount at the right time. Dosages and their frequency are determined by the desire to assure a consistent and steady amount of medication in the blood system and by the length of time the drug remains active. A drug regimen is likely to last several months, but some patients may only require short-term therapy. Others may need medication for a year or longer.

Terminating medication requires as much care as initiating it. Drugs used in the treatment of anxiety disorders should be phased out gradually under direct supervision of a physician.

What Medications Are Used to Treat Anxiety Disorders?

Azaspirones

Azaspirones is a class of drug effective in the treatment of GAD. It works gradually over 2-4 weeks to relieve symptoms of GAD. It does not cause sedation, impair memory or balance, nor does it potentiate the effects of alcohol. It is not habit forming and can be discontinued without causing withdrawal symptoms. The drug is generally well tolerated and the side effects are not usually serious enough to make most people stop taking it.

Most of the benzodiazepines are effective against generalized anxiety disorder (GAD). Some drugs in this group are also used to treat panic disorder and social phobia.

Benzodiazepines are relatively fast-acting drugs. Their principal side effect is drowsiness, but they have the potential for dependency. Individuals taking benzodiazepines can experience a return of their anxiety symptoms when the drug is discontinued. They may also experience temporary withdrawal symptoms. These problems can be minimized if the patient and doctor work together.

Beta blockers

These drugs are used mainly to reduce certain anxiety symptoms like palpitations, sweating and tremors, and to control anxiety in public situations. They often are prescribed for individuals with social phobia. Beta blockers reduce blood pressure and slow the heartbeat.

Tricyclics (TCAs)

These drugs were first used for treating depression, but some are also effective in blocking panic attacks. Most tricyclics may also reduce symptoms of post- traumatic stress disorder (PTSD) and some are effective against obsessive-compulsive disorder (OCD)

Tricyclics generally take two or three weeks to take effect. Some individuals feel the drugs' most annoying side effect is weight gain. Other side effects include drowsiness, dry mouth, dizziness and impaired sexual function.

These drugs are used in the treatment of panic disorder, social phobia, PTSD and sometimes OCD, but they require dietary restrictions and some doctors prefer to try other treatments first. Anyone taking a MAO inhibitor must avoid other medications, wine and beer, and food such as cheeses that contain tyramine.

Serotonin Reuptake Inhibitors (SRIs)

These are the newest medicines available for treating anxiety disorders. SRIs may be considered a first-line of treatment for panic disorder, and they often are effective against obsessive-compulsive disorder (OCD). Traditionally used to treat depression, the safety and convenience of SRIs (they require once-a-day dosing) have made them among the most widely-used drugs in the world. The most common side effect, which tends to resolve over time, is mild nausea. Sexual dysfunction, primarily ejaculatory delay, also has been reported.

New medications

New medications are being developed and tested constantly. Your doctor will advise you if one of these newer drugs is appropriate.

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