In our pill-obsessed world, there’s a medication for everything – and quite a few for anxiety in particular.
What exactly do anti-anxiety medications do? And are they always the right choice – or is there a more natural, side effect-free answer? Here’s what I found out about anti-anxiety drugs.
Cutting Off the Anxiety Response
Most anti-anxiety medications work by short-circuiting the anxiety response system. They typically work in the brain, either supporting neurotransmitters, blocking anxiety or sedating the patient.
Because there are so many ways drugs can stop anxiety, there are several classes available. Some treat anxiety on the spot (tranquilizers are most common for this effect). Others work longer-term and take several weeks to build up before the sufferer begins to see results.
Different Classes of Anxiety Medications
What They Are: Tranquilizers, or Benzodiazepines, produce an immediate calming effect on the body and the mind by reducing mind activity.
What Types are Available: The tranquilizer class includes Valium (Diazepam), Xanax (Alprazolam), Klonopin (Clonazepam) and Ativan (Lorazepam)
Why They’re Used: Tranquilizers are fast-acting, typically bringing relief in 30 minutes or less. This makes them ideal for panic attacks or intense anxiety.
Side Effects: Drowsiness; lack of energy; impaired thinking or judgment; confusion/disorientation; depression; clumsiness/lack of coordination; blurred or double vision; stomach upset.
What They Are: Antidepressants work on the brain’s neurotransmitters to either build them up, or keep existing neurotransmitters in place long enough to calm the mind.
What Types are Available: Selective serotonin reuptake inhibitors (SSRIs), such as Prozac, Zoloft, Lexapro, Celexa and Paxil; monoamine oxidase inhibitors (MAOis), an older class of antidepressants; tricicylic antidepressants (TCAs) and atypical antidepressants.
Why They’re Used: The link between anxiety and depression is well-known. Though it may seem counter-intuitive to use an antidepressant for a too-active, panicked mind, using antidepressants can actually “even things out,” producing less anxiety as well as less depression over time.
Side Effects: Weight gain; nervousness; headaches; nausea; sleepiness; sexual dysfunction/erectile dysfunction (ED); dizziness upon standing; particularly in younger patients, possible suicidal thoughts.
What They Are: Beta blockers were originally used to treat high blood pressure, but were quickly found to have anti-anxiety effects. Generally, when beta blockers are used for anxiety, they are prescribed off-label (the primary effect is still considered to be blood pressure reduction).
What Types are Available: There are many types of beta blockers available for blood pressure and heart conditions, but the two most commonly prescribed beta blockers for anxiety are Inderal (Propranolol) and Tenormin (Atenolol).
Why They’re Used: Anxiety is often like a feedback loop where the individual suffers physical effects (feelings of unreality, a rapid heart beat, etc.), then feel even more anxiety because of those perceptions. Beta blockers work on the physical symptoms of anxiety, hence reducing the emotional effects (fear of the feelings). They work particularly well for social anxiety and social phobias.
Side Effects: Slowed pulse; fatigue/sleepiness; nausea; dizziness/lightheadedness.
Withdrawal Symptoms of Anti-Anxiety Medications
Many anti-anxiety drugs can cause withdrawal symptoms when stopped suddenly. If you have been taking your anti-anxiety medication for some time and wish to stop, consult your doctor for directions on how to taper.
Generally, the older antidepresseants (MAOIs), tranquilizers such as Xanax or Valium and SSRIs with a short half-life (for example, Paxil) will produce the most withdrawal effects. Not everyone will experience these in the same way, and some people don’t experience any withdrawal issues when stopping anti-anxiety medication.
Withdrawal symptoms will vary. Most will include an intense craving for the drug/medication. Sleeplessness or hypersomnia (too much sleep), extreme anxiety and agitation, dry mouth, dizziness, constipation and in some cases, palpitations and cold sweats are common side effects of sudden drug discontinuation.
Occasionally, more rare but potentially dangerous/life-threatening conditions may occur when stopping some anxiety medications. These include seizure and rapid pulse or rapid heartbeat. Consult your doctor; DO NOT discontinue anti-anxiety medications suddenly and on your own.
Are All Anti-Anxiety Medications Bad, Then?
So, with all the potential pitfalls, are all anti-anxiety medications a bad thing?
No. I’ve known many individuals (including myself) who used anti-anxiety drugs on a temporary basis to quell issues that were truly interfering with their lives, families and careers (agoraphobia, for example, or fainting).
However, if you haven’t started a drug regimen yet, I suggest trying a more natural approach first. I’m not overriding your doctor’s orders – see her first, and follow her directions. If she gives you the go-ahead, try natural methods for anxiety reduction. We’ve outlined quite a few of them on this site.
There’s also some drugless self-help options that may be effective for you.
If you do decide to try an anti-anxiety medication, be sure to bring a list of questions for your doctor. Don’t be shy – this is your mind and your body. Make sure you’re clear on any and all potential side effects and interactions with any other drugs you may be taking. That way you’ll be able to make an informed choice that fits your lifestyle and needs.