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What You Need to Know About Anxiety Medication: Pros and Cons

Anxiety is a broad term used to describe a naturally occurring phenomenon in the human body.  Stress, worry, and anxiety are all natural reactions to the problems of life. And while a healthy amount of anxiety can be helpful motivation, for some, it can be a recurring hindrance to productivity rooted in a biological condition known as anxiety disorder. In fact, it’s estimated that more than 40 million adults in the U.S., roughly 18 percent, suffer from some form of anxiety disorder. In other words, nearly 1 in 5 American adults.

There is a whole family of diagnoses that fall under the anxiety classification. The most common include:

Common Anxiety Diagnoses

  • General Anxiety Disorder
  • Social Anxiety Disorder
  • Separation Anxiety Disorder
  • Panic Disorder

Related Disorders

  • Posttraumatic Stress Disorder (PTSD)
  • Obsessive Compulsive Disorder (OCD)

To treat these and other anxiety disorders, there are a variety of medication options available. However, medication is most helpful when combined with some form of therapy and treatment that addresses the underlying psychological triggers of anxiety. If you’re considering pursuing some form of medication to treat anxiety, here’s what you need to know about the options available to you.

Benzodiazepines

Benzodiazepines are one of the most widely used forms of medication used to treat anxiety, and among the most prescribed drugs in the world. However, they are also one of the most highly abused. Used properly, “benzos” can provide significant relief from anxiety, but they contain physically addictive qualities and are highly dangerous when combined with other depressants such as alcohol. There are hundreds of variants, but the most commonly prescribed forms are:

  • Valium (Diazepam)
  • Xanax
  • Rohypnol (Flunitrazepam or Roofies)
  • Restoril
  • Librium (Chlordiazepoxide)
  • Serax
  • Ativan (Lorazepam)
  • Klonapin (clonapezam)

Benzos work in a similar manner to most sedative drugs in that they shut down neurotransmitters, reducing feelings such as anxiety and tension. Unlike most sedatives, benzodiazepines operate by connecting to specific receptor molecules of non-critical body functions. In other words, while most sedatives partially shut down our whole body, benzos only shut down cells that participate in thinking and worrying, not breathing and surviving.

It may seem like a miracle drug, but benzos are known to hamper brain function and in some cases cause amnesia. Benzos suppress brain synapses from firing, meaning long term use can significantly hinder brain function. Rohypnol (roofies) are an especially potent form of benzos that have been known to be slipped in drinks, causing temporary amnesia or blackouts. When taken in small doses, benzos are known to cause lightheadedness, poor muscle coordination, and vertigo among other side effects.

Benzodiazepines are used to address anxiety because of their relaxing effects, but their potential for abuse is high. Tolerance will develop to any drug over time, and benzos are no different. Even after using for a period of two weeks or more, withdrawal can cause negative side effects. By suppressing the central nervous system for so long, sudden withdrawal can cause brain synapses to overfire. This can result in panic attacks, tremors, headaches, insomnia, sweating, and ironically, increased anxiety. For some, this could even result in epileptic seizure. There is also the challenge of psychologically overcoming a reliance on the numbing effects produced by these drugs.

Pros
  • Effective for short term relief
  • Not dangerous to life critical body functions (unless combined with other sedatives)
  • Useful sedative for surgery, immediate seizure prevention
Cons
  • Highly addictive when used for long term treatment
  • Dangerous withdrawal symptoms such as seizures, anxiety, physical cravings
  • Long term use can hamper brain function

Only use benzos when prescribed by a physician. Even then, be careful about how much you are taking and how frequently, and make sure that you only plan being on benzos for a short period of time. Likelihood of addiction varies from person to person, but it is safe to say you should not rely on benzo usage for more than a month, unless you’re experiencing chronic physical pain.

Antidepressants (SSRI’s & SNRI’s)

Antidepressant is an umbrella term for a wide variety of medications used to treat symptoms of depression. However, due to the way they increase the brain’s availability of feel good chemicals such as serotonin and dopamine, they can also help alleviate symptoms of anxiety. One of the most common types of antidepressants are SSRI’s, or Selective Serotonin Reuptake Inhibitors. When compared to benzodiazepines, SSRI’s and SNRI’s have a much lower risk for dependency and abuse. That is because they typically take 4-6 weeks of regular use before effects take place. Some of the most common include:

SSRI’s

  • Prozac (Fluoxetine)
  • Zoloft (Sertraline)
  • Paxil (Paroxetine)
  • Lexapro (Escitalopram)
  • Celexa (Citalopram)

SNRI’s

  • Cymbalta (Duloxetine)
  • Fetzima (Levomilnacipran)
  • Effexor (Venlafaxine)
  • Pristiq (Desvenlafaxine)

There are many variations of antidepressant drugs, but most do the same thing. The main goal of these drugs is to bring neurotransmitters back into balance and alleviate symptoms of depression. SSRI’s and SNRI’s do this by increasing the availability of feel good chemicals in the brain. SSRIs increase serotonin, while SNRIs increase both serotonin and norepinephrine, which along with the dopamine are three chemicals most closely linked to depression.

Antidepressants aren’t considered addictive, however treatment needs to be carefully administered. Stopping abruptly or missing several doses can cause withdrawal-like symptoms such as nausea, dizziness, lethargy, and anxiety. It also takes time for SSRI’s and SNRI’s to take effect. In the 4-6 weeks that the body becomes acclimated to the medication, a variety of symptoms could occur. A small number of users report thoughts of suicide, and many report occasional dry mouth, insomnia, nervousness, dizziness, and sexual dysfunction.

Pros
  • Less potential for developing an addiction than benzodiazepines
  • Less disruptive to brain chemistry than benzodiazepines
  • Can be used for a wide variety of anxiety disorders
Cons
  • Time it takes to become effective may be a deterrent to continued use
  • Could cause health complications when combined with other drugs such as alcohol and anti-inflammatories.
  • Reduced appetite

Antidepressants medications can go a long way towards treating symptoms of anxiety disorders. However, they should never be considered as a sole approach or fix. Combining antidepressants with continued therapy, along with healthy diet and exercise will increase your chances of success.

Other Options

Beta Blockers

Beta blockers (known as beta-adrenergic blocking agents) are used to reduce blood pressure. They also block the effects of adrenaline, in effect reducing your heart rate. Doctors typically prescribe beta blockers to treat high blood pressure and chest pain, but they have also been mildly useful in treating symptoms of anxiety.

Antihistamines

The most common antihistamine for treating anxiety is Hydroxyzine. Antihistamines are traditionally used to reduce the effects of allergies, reducing swelling and inducing lethargy. Antihistamines are typically prescribed for anxiety on a short-term basis, and shouldn’t be considered for a long term solution.

Tricyclic Antidepressants

Tricyclic antidepressants work similar to SSRI’s and SNRI’s in that they increase the availability of feel good chemicals in the brain. However, these are typically pursued after other options haven’t worked. Tricyclic antidepressants work by keeping more serotonin and norepinephrine available in the brain, but the side effects are considered more drastic than other similar antidepressants. For example, nausea, diarrhea, constipation, and anxiety.

Pros
  • Less disruptive to brain chemistry than benzos and SSRI/SNRI’s
  • Effects are more immediate than SSRI/SNRI’s
  • Can effectively treat short term anxiety without too many negative side effects
Cons
  • Doesn’t address long term solution for anxiety
  • Can impair motor function
  • Not helpful for reducing intense feelings of sudden panic

Regardless of what medication sounds like the best option for you, it’s best to confer with a clinical professional before pursuing any treatment option. Likewise, any treatment option should be accompanied by lifestyle changes aligned with addressing the psychological underpinnings of your anxiety. If you believe that you or a loved one may be self-medicating to treat an anxiety disorder, reach out and consult with a medical professional to talk about possible treatment options.

If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

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Author Bio: Jackson Bentley works as a content manager for Landmark Recovery, a Louisville KY Rehab Center offering residential treatment, detox, and intensive outpatient services. A graduate of Arizona State University, Jackson has been involved in drug and alcohol addiction treatment for two years and has been professionally writing for more than four years for a variety of vertical trade publications, including for the healthcare, technology, and retail industries.

The opinions and views expressed in this guest blog do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in this article or linked to herein.

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