Antianxiety Medications Anti-Anxiety Drugs
Antianxiety Medications Anti-Anxiety Drugs Introduction
Everyone experiences anxiety at one time or another "butterflies in the
stomach" before giving a speech or sweaty palms during a job interview
are common symptoms. Other symptoms of anxiety include irritability, uneasiness,
jumpiness, feelings of apprehension, rapid or irregular heartbeat, stomach ache,
nausea, faintness, and breathing problems. Anxiety is often manageable and mild.
But sometimes it can present serious problems. A high level or prolonged state
of anxiety can be very incapacitating, making the activities of daily life difficult
anxiety, other anxiety disorders are panic, phobia, obsessive-compulsive
disorder (OCD), and post
traumatic stress disorder. Phobias, which are persistent, irrational fears
and are characterized by avoidance of certain objects, places, and things, sometimes
accompany anxiety. A panic attack is a severe form of anxiety that may occur
suddenly and is marked with symptoms of nervousness, breathlessness, pounding
heart, and sweating. Sometimes the fear that one may die is present.
Antianxiety medications help to calm and relax the anxious person and remove
the troubling symptoms. There are a number of antianxiety medications currently
available. The preferred medications for most anxiety disorders are the benzodiazepines.
In addition to the benzodiazepines, a non-benzodiazepine, buspirone (BuSpar),
is used for generalized anxiety disorders.
Antidepressants are also effective
for panic attacks and some phobias and are often prescribed for these conditions.
They are also sometimes used for more generalized forms of anxiety, especially
when it is accompanied by depression. The medications approved by the FDA for
use in OCD are all antidepressants clomipramine, fluoxetine, and fluvoxamine.
The most commonly used benzodiazepines are alprazolam (Xanax) and diazepam (Valium),
followed by chlordiazepoxide (Librium, Librax, Libritabs). Benzodiazepines are
relatively fast-acting medications; in contrast, buspirone must be taken daily
for 2 or 3 weeks prior to exerting its antianxiety effect. Most benzodiazepines
will begin to take effect within hours, some in even less time. Benzodiazepines
differ in duration of action in different individuals; they may be taken two
or three times a day, or sometimes only once a day. Dosage is generally started
at a low level and gradually raised until symptoms are diminished or removed.
The dosage will vary a great deal depending on the symptoms and the individual's
Benzodiazepines have few side effects. Drowsiness and loss of coordination
are most common; fatigue and mental slowing or confusion can also occur. These
effects make it dangerous to drive or operate some machinery when taking benzodiazepines
especially when the patient is just beginning treatment. Other side effects
are rare. Benzodiazepines combined with other medications can present a problem,
notably when taken together with commonly used substances such as alcohol. It
is wise to abstain from alcohol when taking benzodiazepines, as the interaction
between benzodiazepines and alcohol can lead to serious and possibly life-threatening
complications. Following the doctor's instructions is important. The doctor
should be informed of all other medications the patient is taking, including
over-the-counter preparations. Benzodiazepines increase central nervous system
depression when combined with alcohol, anesthetics, antihistamines, sedatives,
muscle relaxants, and some prescription pain medications. Particular benzodiazepines
may influence the action of some anticonvulsant and cardiac medications. Benzodiazepines
have also been associated with abnormalities in babies born to mothers who were
taking these medications during pregnancy.
With benzodiazepines, there is a potential for the development of tolerance
and dependence as well as the possibility of abuse and withdrawal reactions.
For these reasons, the medications are generally prescribed for brief periods
of time days or weeks and sometimes intermittently, for stressful situations
or anxiety attacks. For the same reason, ongoing or continuous treatment with
benzodiazepines is not recommended for most people. Some patients may, however,
need long-term treatment. Consult with the doctor before discontinuing a benzodiazepine.
A withdrawal reaction may occur if the treatment is abruptly stopped.
Symptoms may include anxiety, shakiness, headache, dizziness, sleeplessness,
loss of appetite, and, in more severe cases, fever, seizures, and psychosis.
A withdrawal reaction may be mistaken for a return of the anxiety, since many
of the symptoms are similar. Thus, after benzodiazepines are taken for an extended
period, the dosage is gradually tapered off before being completely stopped.
Although benzodiazepines, buspirone, tricyclic antidepressants, or SSRIs are
the preferred medications for most anxiety disorders, occasionally, for specific
reasons, one of the following medications may be prescribed: antipsychotic medications;
antihistamines (such as Atarax, Vistaril, and others); barbiturates such as
phenobarbital; and beta-blockers such as propranolol (Inderal, Inderide). Propanediols
such as meprobamate (Equanil) were commonly prescribed prior to the introduction
of the benzodiazepines, but today rarely are used.
BACK TO THE MENU