Anxiety disorders affect more than 18 percent of adults in the U.S. in a given year, according to the National Institute of Mental Health. These disorders cause symptoms that can make daily activities difficult. Medications are sometimes used to help alleviate some symptoms of an anxiety disorder. Some of these medications, such as benzodiazepines, may be addictive and are used only on a short-term basis. Other antianxiety medications can be used on a long-term basis without the risk of addiction. See your doctor to determine whether medication is appropriate to include in the management plan for your anxiety disorder.
SSRIs and SNRIs
Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are medications that alter the balance of chemical messengers in the brain. These drugs were first used to treat depression, but are currently recommended as first-choice medications for treating certain anxiety disorders, according to the World Federation of Biological Psychiatry. SSRIs are particularly effective for obsessive-compulsive disorder and post-traumatic stress disorder. SNRIs are generally recommended for anxiety disorders. These medications can take 4 to 6 weeks to begin working. While SSRIs and SNRIs are not addictive, there can be side effects if the medication is stopped abruptly.
Examples of SSRIs and SNRIs that might be prescribed for anxiety disorders include:
-- SSRIs: citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft)
-- SNRIs: duloxetine (Cymbalta) and venlafaxine (Effexor)
The World Federation of Biological Psychiatry recommends pregabalin (Lyrica) as a first-choice medication specifically for the treatment of generalized anxiety disorder, but not other anxiety disorders. Although pregabalin is not approved by the U.S. Food and Drug Administration for the treatment of any anxiety disorder, the medication can alter the release of certain chemical brain messengers that might reduce symptoms of anxiety. When taken as directed, pregabalin is not addictive. However, there are reports of misuse and abrupt discontinuation can cause uncomfortable withdrawal symptoms.
Buspirone was first approved by the FDA for the treatment of generalized anxiety disorder in 1986, when it was hailed as an nonaddictive alternative to benzodiazepines such as diazepam (Valium). The exact mechanism of action of buspirone remains unknown, but it appears to act as a mild tranquilizer by increasing serotonin and decreasing dopamine levels in the brain. Buspirone may take up to 2 weeks to start relieving anxiety symptoms, compared to 30 to 60 minutes for benzodiazepines. Unlike benzodiazepines, however, buspirone can be used for more than a few weeks without risking addiction.
Beta blockers are sometimes used to treat short-term, physical symptoms of anxiety like a rapid heart rate. But they do not address the brain chemical imbalances that might fuel anxiety disorders. These nonaddictive medications are most often prescribed for people with social phobias, who are greatly affected by the physical symptoms of anxiety in certain situations. Beta blockers do not treat the emotional symptoms of anxiety, however, and are not FDA-approved for anxiety disorder treatment. Examples of beta blockers that are sometimes prescribed for anxiety include propranolol (Inderal) and atenolol (Tenormin).
There are many different types of anxiety disorders, and medicine for one type may not be helpful for another. Additionally, people react differently to different medications. Therefore, treatment for anxiety disorders must be individualized. Working with your doctor is the optimal way to come up with a treatment plan that works best for you. Your plan may or may not include medications, and recommended medicines can change over time as new drugs become available. If your doctor recommends medication, talk with her about the potential risks and benefits -- including the addiction potential of any drug you are considering.
Reviewed and revised by: Tina M. St. John, M.D.