Anxiety disorder treatment typically involves a combination of lifestyle changes, psychotherapy and medication. If you’re uncertain about taking medication to treat your anxiety disorder, you’re not alone. Many people who suffer from anxiety disorders aren’t sure if medication is right for them. And, while non-pharmaceutical treatments may not relieve your anxiety as quickly as medication can, they can be just as effective in the long run, with fewer side effects. Don’t make a decision about whether to take medication for anxiety until you’ve got all the facts.
There are several types of medication used for the treatment of anxiety disorders, including tranquilizers, which are also prescribed as muscle relaxants and sleeping pills. The most common drugs prescribed for anxiety are benzodiazepines, like alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium) and clonazepam (Klonopin). These fast-acting drugs bring relief for anxiety symptoms with 30 to 60 minutes. They’re best for the treatment of acute anxiety, like panic attacks.
Antidepressants are also prescribed for the treatment of anxiety disorders. SSRIs, MAOIs, tricyclic antidepressants and other antidepressants relieve anxiety in much the same way that they relieve depression symptoms. However, it can take four to six weeks for relief to occur, so these drugs won’t help you if you take them during a panic attack. They’re best for chronic anxiety treatment.
Buspirone (BuSpar) is another newer drug used for anxiety disorder treatment. It’s a mild tranquilizer that increases serotonin and decreases dopamine. It’s slow-acting and takes about two weeks to start working. It can’t be used to treat panic attacks, but it has several advantages for people seeking anxiety relief. It doesn’t impair concentration or memory, like benzodiazepines, it’s not addictive and it doesn’t cause significant withdrawal effects.
Beta-blockers were designed to treat heart problems and hypertension, but they may also be prescribed for anxiety disorder treatment, especially phobias and performance anxiety issues. They block the action of norepinephrine, a stress hormone that causes the fight-or-flight response implicated in anxiety. They can help control physical symptoms of anxiety like shaky hands, rapid heartbeat, sweating, dizziness and trembling of the voice. They’re not good for relieving the emotional symptoms of anxiety, but they can help you calm your nerves in a situation that causes you anxiety, like giving a speech or going to a job interview.
It’s totally normal to be concerned about the safety of anti-anxiety medications. Some of the older anti-anxiety drugs, like benzodiazepines, are addictive and should not be used long-term. They can cause dangerous side effects, including impaired thinking, clumsiness, slurred speech, nausea, blurred vision, confusion, drowsiness, and dizziness. People who take these drugs over the long term may develop depression. Benzodiazepines can also cause blunting or numbing of the emotions; in blocking feelings of anxiety, they also block other feelings, including feelings of pleasure.
Benzodiazepines have also been known to cause what’s called paradoxical reactions, which include:
Though paradoxical reactions are rare, they can be dangerous.
Other medications for anxiety disorder treatment are also not without their risks. Many antidepressants used to treat anxiety can cause side effects including sexual dysfunction, nausea, headaches, weight gain, stomach upset, dizziness, sleepiness, and nervousness. If stopped too abruptly, these drugs can cause withdrawal syndrome. In young people, there is a small risk that antidepressant use can increase suicidal thoughts and feelings of hostility.
Of all the drugs used for anxiety disorder treatment, buspirone and beta-blockers have the fewest risks and side effects. However, these drugs are only effective for the treatment of a limited range of anxiety disorders, so they may not be right for you.
Medications for the treatment of anxiety disorders aren’t for everyone. If you’re over 65, anti-anxiety drugs could increase your risk of falls, accidents, memory loss, and cognitive impairment. You should also avoid anti-anxiety drugs if you are pregnant, breastfeeding, or have a history of substance abuse.
Medication for anxiety can be a valuable part of anxiety treatment, but it’s not right for everyone. Before you decide whether or not to take anti-anxiety medication a part of your treatment plan, educate yourself about the different medications, their side effects, and their safety risks.
Since 2003, the Delray Center for Healing has provided exceptional psychiatric and therapeutic care for mental health, eating, and substance use disorders. To learn more about our philosophy and treatment approach, download our free e-book, “Psychiatry Redefined,” written by our founder and medical director, Raul J. Rodriguez, MD.