PART II:
TYPES OF ANTI-ANXIETY MEDICATIONS
The most common type of medications prescribed for anxiety include the traditional benzodiazepines as well as newer options such as antidepressants (see issues #19 July 3, and #24 July 8, ) and drugs called beta-blockers.
Do not use this information as a substitute
for the knowledge and judgment
of a prescribing doctor.
The reason I give you this list is because it may be helpful to know the different class types of a medication in case one class doesn’t seem to work for you. Another class type might do the trick.
Drugs (by brand names)
commonly prescribed for
ANXIETY AND STRESS
> SSRIs which are antidepressants – for example, Celexa, Zoloft, Prozac, Paxil, Effexor, Luvox
> Tricyclic anti-depressants - Elavil, Vanatrip
> Antiadrenergic agents - Minipress
GENERALIZED ANXIETY DISORDER
> SSRIs – Lexapro, Cymbalta, Celexa, Paxil, Effexor, Pexeva
> Atypical antipsychotics – Seroquel
> Gamma-aminobutyric acid analogs - Lyrica
OBSESSIVE COMPULSIVE DISORDER
> Atypical antipsychotics – Abilify, Seroquel, Zyprexa
> Tricyclic antidepressants – Anafranil
> SSRIs – Celexa, Effexor, Lexapro, Luvox, Paxil, Pexeva, Prozac, Zoloft
> 5HT3 receptor antagonists - Zofran
PANIC DISORDER
> Benzodiazepines – Alprazolam Intensol, Ativan, Klonopin (clonazepam), Niravam, Lorazepam Intensol, Xanax
> Tricyclic antidepressants – Anafranil, Aventyl Hydrochloride (nortriptyline), Pamelor, Tofranil
> Tetracyclic antidepressants - Ludiomil
> SSRIs – Celexa, Effexor, Luvox, Paxil, Pexeva, Prozac, Rapiflux, Zoloft
> SNRIs - Pristiq
> Miscellaneous antidepressants – Aplenzin, Budeprion, Buproban (also used to help stop smoking), Serzone, Wellbutrin
> Miscellaneous anxiolytics, sedatives & hypnotics – BuSpar or Vanspar (buspirone)
POST TRAUMATIC STRESS DISORDER
> Atypical antipsychotics – Seroquel, Abilify, Risperdal, Saphris
> SSRIs – Zoloft, Paxil, Pristiq, Luvox
> Tricyclic antidepressants – Elavil, Vanatrip (amitriptyline)
> Antiadrenergic agents – Minipress
SOCIAL ANXIETY DISORDER
> SSRIs – Zoloft, Paxil, Effexor, Paxil, Luvox, Pexeva
> Atypical antipsychotics – Risperdal
> CNS (central nervous system) stimulants - Strattera
A word about some of these drugs....
TRANQUILIZERS & BENZODIAZEPINES
These type of drugs are also known as sedatives which slow down your central nervous system. They usually have a relaxing and calming effect. They are also prescribed as sleeping pills and muscle relaxants. The great thing about them is you can take them on a “as needed basis” because they work within an hour. Other drugs take longer.
Benzodiazepines are the most common class of tranquilizers. Some of the popular ones are Xanax (brand name, common name is alprazolam), Klonopin (or clonazepam), Valium (or diazepam) and Ativan (or lorazepam). “Benzos” are fast acting and usually bring relief within 30 minutes to 1 hour. They are very effective for panic attacks but .... they have drawbacks, the biggest one of which is a tendency towards serious addiction for many people. I will talk about side effects and safety concerns next time.
In the meantime, if you decide to take a benzodiazepine ...
> see your prescribing doctor (GP or psychiatrist) regularly and make sure s/he understands anxiety disorders and anti-anxiety medications well;
> s/he should also be knowledgeable about benzodiazepines and their risk of addiction and be willing to monitor your use of them;
> don’t stop your medication without consulting your doctor first;
> and if you take it for more than a month you should gradually reduce the dosage with your doctor’s supervision so that you don’t become addicted to it;
> and you find that you need to take more and more of it to achieve the same relief you may be getting addicted to it. Talk to your doctor about withdrawing.
ANTIDEPRESSANTS
Because of some of the problems with tranquilizers and benzodiazepines other medications are being prescribed more often as risk of dependence and abuse of them is smaller. The alternatives include antidepressants, beta blockers and a drug called Buspirone.
Antidepressants have been found to help with anxiety although they take longer to begin working and provide relief. Unlike tranquilizers and benzodiazepines you can’t take them on a “as needed” basis. They are used for more chronic anxiety problems rather than sudden panic attacks
The antidepressants most used for anxiety are the SSRIs or selective serotonin reuptake inhibitors such as Prozac, Zoloft, Paxil, Lexapro and Celexa. These have been used to treat panic disorder, obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD).
A word of caution about antidepressants – sometimes an antidepressant may have the opposite effect of what you want, which is to increase your anxiety. You may have to try a different one to get the relief you need or a different type of drug.
BETA-BLOCKERS
These drugs are most commonly used for high blood pressure and heart problems but they are also sometimes prescribed for anxiety. They work by blocking the effects of a stress hormone called norepinephrine which is involved in the “fight or flight response” so they help control the physical symptoms of anxiety such as rapid heart rate, trembling voice, sweating, dizziness, and/or shaky hands. They are most helpful for phobias and especially for social phobia and performance anxiety.
BUSPIRONE (BUSPAR)
Buspirone is a somewhat newer drug used for anxiety and acts as a tranquilizer. It works similarly to the antidepressants SSRIs. It is slow acting and takes about two weeks to start working on anxiety. Its advantages are it’s not as sedating as the older anti-anxiety drugs, doesn’t impair memory or coordination, withdrawal effects are minimal and it’s not very addictive. Unfortunately, Buspirone seems to only work for Generalized Anxiety Disorder and not the other anxiety disorders.
These are the drugs most commonly prescribed for anxiety, however, as in the list above there are other types of drugs prescribed for anxiety as well. If none of these medications work for you it’s still possible to find something that will. And don’t forget that medication may not be the answer for you, or only a partial solution to your problem. There are a number of other things you can do and which I will cover at a later date.
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