Anxiety is a normal reaction to stress. It helps one deal with the tensions of everyday life in coping with challenging situations. However, when anxiety becomes extreme, and when the symptoms interfere with daily life and the ability to function, it can become a debilitating disorder. According the National Institute of Mental Health, the most common anxiety disorders include generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, social phobia and post-traumatic stress disorder. Fortunately, several medications can treat and relieve the symptoms of anxiety disorders.
Antidepressants -- SSRIs, Tricyclics, MAOIs
According to Ross J. Baldessarini, in "The Pharmacological Basis of Therapeutics," though developed to treat depression, antidepressants can also prove effective for anxiety disorders. It usually takes 4 to 6 weeks before symptoms begin to improve, so it becomes important to continue taking these medications until they begin to work.
Selective Serotonin Reuptake Inhibitors
According to Laszlo A. Papp, M.D. in "Kaplan & Sadock's Comprehensive Textbook of Psychiatry," selective serotonin reuptake inhibitors (SSRIs) are the newest class of antidepressants. SSRIs alter the levels of the neurotransmitter serotonin in the brain, which improves communication between brain cells. Fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil), and citalopram (Celexa) include some of the SSRIs used to treat panic disorder, obsessive-compulsive disorder, post traumatic stress disorder, and social phobia. Venlafaxine (Effexor) proves effective in treating generalized anxiety disorder. Although SSRIs produce fewer side effects than older antidepressants, patients taking these drugs sometimes experience nausea, nervousness, insomnia or sexual dysfunction. However, adjusting the dosage can alleviate these symptoms.
Tricyclics
Although tricyclics are older than SSRIs, they work as well as SSRIs for treating anxiety disorders other than obsessive-compulsive disorder. This class of medications includes imipramine (Tofranil), which effectively treats panic disorder and generalized anxiety disorder, and clomipramine (Anafranil), which is the only tricyclic antidepressant effective for treating obsessive-compulsive disorder. Side effects of these medications may include dizziness, drowsiness, dry mouth, and weight gain. However, changing the dosage can usually improve these side effects.
Monoamine Oxidase Inhibitors
Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressants. Those most often prescribed for anxiety disorders include phenelzine (Nardil), followed by tranylcypromine (Parnate) and isocarboxazid (Marplan), which prove effective in treating panic disorder and social phobia. People who take MAOIs must avoid certain foods, beverages, and medications that can interact with their MAOI and cause dangerous increases in blood pressure. MAOIs can also react with SSRIs to produce a serious condition called "serotonin syndrome," which can cause confusion, hallucinations, muscle stiffness, seizures, and changes in blood pressure or heart rhythm.
Anti-Anxiety Drugs
The anti-anxiety medications called benzodiazepines start working more quickly than antidepressants. They have few side effects other than drowsiness. Because people can get used to them and may need increasingly higher doses to get the same effect, physicians generally prescribe benzodiazepines for short periods of time. However, people with panic disorder can take benzodiazepines for up to a year without harm. Clonazepam (Klonopin) treats social phobia and generalized anxiety disorder; lorazepam (Ativan) proves helpful for panic disorder; and alprazolam (Xanax) treats both panic disorder and generalized anxiety disorder. Buspirone (Buspar), an azapirone, is a newer anti-anxiety medication used to treat generalized anxiety disorder. Possible side effects include dizziness, headaches, and nausea. Unlike benzodiazepines, buspirone must be taken consistently for at least 2 weeks to achieve an anti-anxiety effect.
Beta-Blockers
Beta-blockers, such as propranolol (Inderal) and atenolol (Tenormin), which treat heart conditions, can also prevent the physical symptoms that accompany certain anxiety disorders, particularly social phobia. When anticipating a feared situation (such as performing before a large audience), a beta-blocker may help keep the physical symptoms of anxiety under control.
References
- National Institute of Mental Health: Anxiety Disorders.
- "The Pharmacological Basis of Therapeutics." Ross J. Baldessarini, M.D.; 2001
- "Kaplan & Sadock's Comprehensive Textbook of Psychiatry"; Benjamin J. Sadock, M.D.; 2000
