Things to Know About Anti Anxiety Medication List
The anti anxiety medication list contains several drug classes, namely benzodiazepines, selective serotonin reuptake inhibitors or SSRIs, serotonin- norepinephrine reuptake inhibitors or SNRIs, tricyclic antidepressants or TCAs, and beta-blockers. These medications provide relief of anxiety symptoms and help a person return to normal functioning.
Benzodiazepines for anxiety
Benzodiazepines (BZDs) act on benzodiazepine receptors in the brain and have a rapid anti-anxiety or anxiolytic effect. They are mostly used for the treatment of acute or severe anxiety, agitation, and insomnia. Rapid onset of action is expected from oral benzodiazepines such as Alprazolam (Xanax), Diazepam (Valium), Estazolam (ProSom), Lorazepam (Ativan), and Triazolam (Halcion). If injected intramuscularly, the most reliably absorbed BZDs are Lorazepam and Midazolam (Versed). The shortest-acting BZDs are Alprazolam and Triazolam.
If a person who is severely anxious needs a longer-acting benzodiazepine, the recommended drugs are Diazepam, Clonazepam (Klonopin), Flurazepam (Dalmane), Halazepam (Paxipam), Prazepam (Centrax), and Quazepam (Doral).
The advantages of the longer-acting BZDs over the shorter-acting ones are less-frequent dosing and less severe withdrawal symptoms. However, long- acting BZDs can cause drug toxicity, increased psychomotor impairment, and increased sedation. People who are on BZDs experience increased sleepiness, confusion, and uncoordinated movements. These can present unwanted consequences in work, school, and other coordinated activities such as driving. Benzodiazepine side effects, together with the withdrawal symptoms and the possibility of substance dependence, are the reasons why BZDs are only used for short-term control anxiety.
SSRIs for anxiety
Although SSRIs are generally considered the mainstay drugs for depression, they are also considered first-line drugs for anxiety disorders. They work by increasing the amount of available serotonin in the brain, thereby elevating mood.
Paroxetine (Paxil, Seroxat) was the first SSRI approved for treatment of anxiety in adults. For generalized anxiety disorder, both Paroxetine and Escitalopram (Lexapro) are considered effective. For panic disorders, Paroxetine, Fluoxetine (Prozac), and Sertraline (Zoloft) may be used. Patients who are suffering from other anxiety disorders like Post-Traumatic Stress Disorder (PTSD), social anxiety disorder, and obsessive compulsive disorder (OCD) can benefit from Paroxetine and Sertraline.
SNRIs for anxiety
Venlafaxine (Effexor) and Duloxetine (Cymbalta) are both being used for generalized anxiety disorder. At dosages of 75 mg to 225 mg per day, Venlafaxine has been shown to improve poor concentration, and decrease restlessness, irritability, muscle tension and insomnia. Extended-release Venlafaxine is effective for social anxiety disorder.
TCAs for anxiety
Tricyclic antidepressants or TCAs are useful for some anxiety disorders. For panic disorder with agoraphobia, Imipramine (Imipramil, Deprimin) may be used. The use of Doxepin (Sinequan) has been approved by the FDA for generalized anxiety. For OCD, patients may respond to Clomipramine (Anafranil).
Beta-blockers for anxiety
Beta-blockers or beta-receptor antagonists are usually used to decrease blood pressure and control heart disease. However, they are also utilized off- label for anxiety. They work by inhibiting the effects of norepinephrine, a hormone responsible for the fight-or-flight response. When a person takes beta- blockers, anxiety symptoms such as palpitations, tremors, and dizziness are controlled. Beta-blockers such as Propanolol (Inderal), Atenolol (Tenormin), Labetalol (Normodyne, Trandate), and Metoprolol (Lopressor, Toprol), are considered effective for performance anxiety. In particular, Propanolol, at doses of 10 to 40 mg, is effective for social phobia if taken 20-30 minutes before an expected anxiety-provoking situation. However, beta-blockers are considerably less effective than BZDs and SSRIs for panic disorders.