Anxiety is a persistent condition wherein you may turn nervous and develop inexplicable tension or stress. Your worries can make you restless and can bring down your concentration levels. If the worrisome state of mind persists for say, 5 months or more, it is a clinical condition for which medications are administered. Cognitive behavioral therapies are the first choice for treating anxiety and anxiety-related medical conditions. However, drugs are also used along with cognitive therapies to manage the condition. A proper understanding of drugs available to treat anxiety-related disorders can help you manage them well.
Anxiety is an outcome of a situation that requires new capabilities, and when you are insufficiently endowed with needful skills or capabilities. Fear is generally considered a short term emotion while anxiety is found to last for a longer span of time. Also, a feeling of fear is more to do with a current situation; anxiety is often about an event likely to occur in the near or distant future.
The common signs of anxiety are quite varied; in general, the signs of anxiety depend on the individual experiencing it. Though most of us go through stressful experiences at some point in time in our lives, not all of us experience it as a chronic mental condition. The signs associated with anxiety may show up as both emotional and physical outcomes. Emotional signs are hallucinations, nervousness, inability to focus on things, constant feeling of likely dangers, etc. Physical signs of anxiety include nausea, indigestion, headache, pain in chest accompanied by palpitation, excessive tiredness, pain in lower abdomen, frequent urges to urinate, etc.
Types of anxiety disorders
Anxiety is one of the medical conditions wherein you may feel overwhelmed with supposedly common events occurring in your lives. Anxiety is of many types; a few salient types are –
Generalized anxiety – If you expect improbable events or dangerous outcomes to happen anytime in the near or distant future, you may be suffering generalized anxiety. You may be living in a permanent state of stress owing to such dangerous imagination. This medical condition however cannot be detected through a diagnostic test. But, a trained mental health professional or a psychiatrist can help infer the presence of this clinical condition. The best way to detect its presence is to ask a list of pertinent questions as well as use a few tools available for this purpose.
Phobia – It is a feeling of extreme level of fear. You may be afraid of an event (such as say, scaling dizzy heights, being in open places, etc.) or insects, animals and the like.
Social anxiety – This is a condition wherein you are nervous to stay social. It is often experienced when people need to be with strangers. This affects people who may be introverts. Social anxiety can get more pronounced when you are afraid of being judged by people whom you may not know, especially in a new place, event or setting.
Panic – This is often accompanied by rapid heartrates, chest pain, sweating, etc. The trigger for a spell of panic can either be an event, a physical thing, or your own imagination.
OTC pills for treatment of anxiety
Almost all medications available to treat anxiety or related disorders are sold as prescription drugs only. This is so due to the habit-forming nature of these medicines. You run the risk of getting addicted to these drugs if they are not used under proper medical supervision. Also, if taken without needful medical advice, you may encounter near-fatal or at times, even fatal outcomes. Those who drink alcohol regularly are at an added risk; intake of anxiety medications along with alcohol can lead to an acute spell of drowsiness. People who mixed alcohol with anxiety drugs have experienced slowing down of their breathing cycles. Owing to these dangers, dispensing of anxiety drugs needs to comply with Food and Drug Administration (FDA) regulations.
Prescription medications for treating anxiety
Drugs falling under a class called anxiolytics are commonly prescribed to treat anxiety. These drugs can help treat anxiety-related disorders as well as the associated signs. These are also called as tranquilizing medicines. Their strength is often considered as minor, when compared to antipsychotic or neuroleptic drugs (these drugs are made with powerful chemical compositions to make them tranquilize stronger moods or mental swings). The various types of prescription drugs available to treat anxiety are –
Medicines falling under this family can help manage acute spells of anxieties. These drugs are known for their ability to calm your brain as well as ease your muscles. These are used in the treatment of a wide range of stresses and anxiety. Once you stop taking them, you may develop a few, milder signs of withdrawal. Commonly administered benzodiazepines include alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), etc.
These drugs are also widely administered for anxiety-related disorders. Its use is common for treating generalized anxiety as well as panic attacks. It is relatively a fast-acting drug; positive outcomes may be sensed in about a week’s time from the start of its dosage. With the introduction of selective serotonin reuptake inhibitors (SSRIs), the options to treat anxiety have widened to a greater scale. Common side effects of benzodiazepines include dryness of mouth, muscular cramps, etc.
These drugs – especially, selective serotonin reuptake inhibitors – are prescribed for a wide variety of anxieties. As part of this genre called antidepressants, multiple sub-types of drugs are available. These are serotonin norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, tetracyclic antidepressants and monoamine oxidase inhibitors.
Serotonin norepinephrine reuptake inhibitors (SNRIs)
This class of drugs are prescribed to treat anxiety-related disorders as well as depression. The chemicals in these drugs can make changes in the way your brain receives signals. These changes help reduce depression and other anxieties. This drug mainly works on neurotransmitters such as norepinephrine and serotonin. The most commonly administered drugs under this realm are venlafaxine, desvenlafaxine, duloxetine, levomilnacipran, etc.
Venlafaxine – This medication inhibits the reuptake of transporters (of neurotransmitters) that can affect your moods. Thus, it controls anxieties and depressive spells. Common side effects of this drug include nausea, drowsiness, vomiting, etc. If you have prior medical conditions such as hypertension or high levels of blood cholesterol and other cardiac disorders, you are advised to talk to your treating doctor about the likely risks. The drug may interact with blood thinners (like warfarin), nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen, etc. It is advised to talk to your pharmacist about the drugs you may be currently consuming before taking this SNRI drug.
Desvenlafaxine – This medication is used for treating major spells of anxiety as well as depression. It exhibits needful control on the reuptake of neurotransmitters; you need to note that these transmitters play a key role in influencing your moods. It is however not recommended to consume this drug if you have glaucoma, internal bleeding or an imbalance of electrolyte levels. This medication may interact with drugs you may be currently consuming, such as dabigatran, methylene, etc.
Duloxetine – This medicine is used for the treatment of anxieties and related medical conditions. This drug is a reuptake inhibitor of transmitters such as norepinephrine, serotonin, etc. Key actions of this medication are (a) enhancement of the level of organic substances in brain (b) bringing about a balance of serotonin and (c) reduction of anxieties in patients. Common side effects include difficulties in passing stool, nausea and drowsiness. This drug can interact with ascorbic acid, cetirizine, aspirin, etc.
Selective serotonin reuptake inhibitors (SSRIs)
This class of medications are mainly used to treat anxieties; these drugs have the approval of Food and Drug Administration (FDA) for such usage. Anxiety occurs when the serotonin content in your brain hits a low. Drugs of this class prevent the absorption of serotonin into your blood. Once the chemical is absorbed at lesser than usual level, your brain gains a better access to more of this substance. Such enhanced access of serotonin helps your brain to worry less. This only means the levels of anxiety gets reduced as a final outcome.
Commonly prescribed SSRIs are fluoxetine, escitalopram, fluvoxamine, citalopram, etc. These are sold under brand names Prozac, Lexapro, Luvox, Celexa, respectively.
Fluoxetine – This drug is prescribed for patients experiencing anxiety as well as mood swings. It strengthens the presence of organic substances like serotonin in your brain. It helps restore the right balance of neurotransmitters and thus relaxes anxiety. The common side effects of this drug are a marked decrease in appetite, excessive weariness, insomnia (as well as other sleep related disorders), etc. People with a medical history of strokes and convulsions are advised not to take this drug. It can interact with a few medications such as antipsychotic drugs, antihistamines, etc.
Escitalopram – This medication also helps in increasing the quantum of organic transmitters, and helps strike a balance of such chemicals in your brain. Likely side effects of this drug are troubles while passing stool, dizziness and nausea. You need to inform your treating doctor about pre-existing medical conditions such as renal dysfunction, high blood pressure, etc. – well before starting a course of this drug. This drug is likely to interact with anticonvulsants, drugs taken to treat migraine (a class of medicines called as triptans) and a few antacids.
Fluvoxamine – This medication is used in the case management and treatment of anxiety related disorders such as social anxiety disorder (SAD), panic disorder, obsessive-compulsive disorder (OCD), depression, etc. This drug increases the level of organic substances and thus controls anxieties as well as mood swings including depression. Common side effects triggered by its intake are indigestion, nervousness, chills, insomnia, etc. If you frequently consume alcohol, you are advised to keep away from this medicine. As it can interact with a few nonsteroidal anti-inflammatory drugs and a few antiepileptic medications, you need to keep your doctor informed about the drugs you already take.
Paroxetine – This drug is used for the management of anxiety-based disorders, post-traumatic stress conditions, panic disorders, etc. It enables a finer balance of serotonin and other neurotransmitters such as dopamine, norepinephrine, etc. These actions help restore calmness and as an outcome ease your depression, sadness and anxiety levels. On the whole, this medication helps boost your sleep and stimulate your appetite. It can also lift your emotional wellbeing by easing off panic and hallucinations. Common side effects of this drug are muscular cramping, sleeplessness, nausea, etc. If you are consuming water pills or suffering from liver disorders, you are advised not to take this drug. This drug is known to interact with a few blood thinning drugs (anticoagulants), nonsteroidal anti-inflammatory drugs (NSAIDs), etc.
Citalopram – This drug aids the restoration of organic neuro-substances and enables an apt balance of serotonin and other such transmitters in the brain. In essence, it enables the treatment of anxiety, mood swings and depressive tendencies. Most common side effects are slowing down of pulse rate, dehydration, excessive sweating, etc. If you are already experiencing conditions such as convulsions, glaucoma, cardiac ailments, etc. you are advised to talk to your pharmacist or treating doctor about it. This medicine is known to interact with methylphenidate.
Sertraline – This drug is used for the treatment and case management of anxiety, social phobia, stress related disorders, depression, panic spells, obsessive compulsive problems, mood swings, etc. This medication can stimulate sleep and thus reduce anxiety or stress level. This is widely prescribed to reduce the frequency of panic spells. Common side effects of this drug are allergies on skin (rashes, discoloration, itchiness, blisters, etc.), internal bleeding or blurring of vision. If you have cardiac dysfunction, liver disorders, epilepsy, etc. you need to inform about these conditions to your treating doctor. This medication may interact with a few nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen, etc. It can also interact with a few anticoagulants (blood thinning drugs) like dabigatran, warfarin, etc.
These drugs are administered to patients who have developed resistance or tolerance to other classes of antidepressant medications. The most widely prescribed medications under this class are amoxapine, doxepin, nortriptyline, imipramine, amitriptyline, clomipramine, etc.
Amoxapine – This medication is prescribed for treating extreme levels of anxiety and mood-based disorders. It is also administered while rendering care to patients who experience depression and mental disorders. This drug boosts the presence of organic chemicals in your brain and calms your brain from anxiety or stress. Its side effects include inability to focus or concentrate on things, nausea, blurring of vision, etc. If you have recently had a cardiac arrest or other related conditions, you are not advised to take this medication. Also, if you are a habitual drinker of alcohol, then you may need to tell about your drinking habit to your treating doctor. This drug is capable of interacting with monoamine oxidase inhibiting drugs as well as anticholinergic medications.
Doxepin – This medication is used in the case management of anxiety as well as other mental conditions such as mood imbalances, depression, etc. This drug essentially inhibits the absorption of norepinephrine, serotonin, etc. and makes your brain to have an increased access to such chemicals. It thus enhances the quantum of neurotransmitters in the brain and calms your system from anxieties or other stressful conditions. Its most common side effects are excessive weariness, nausea and feeling drowsy. If you have difficulties in urinating (or other symptoms of incontinence), you are advised not to take this drug. It is likely to interact with antimicrobial medications such as erythromycin, fluconazole as well as a few anticonvulsants (like carbamazepine, etc.).
Nortriptyline – This medication is used for the treatment of sadness among patients caused by anxiety and depression. Main activity of this medication is to ensure the availability of a few essential neurotransmitters in your brain to ease anxiety levels. It is a commonly used drug while caring for patients with anxiety or hallucination. Most common side effects are muscular cramps, indigestion, blurring of vision, etc. You are advised to let your doctor know if you have a medical history of high blood sugar (or other symptoms of diabetes), cardiac problems, enlargement of prostate, etc. This drug may interact with anticoagulants such as warfarin and a few supplements of thyroid.
Imipramine – This drug is administered for treating anxiety and depression. It belongs to a class of medications called tricyclic or selective antidepressants. Among its many actions, the key function is the maintenance of the right balance of neurotransmitters like norepinephrine. It may also be used to stop bedwetting by children during night times; it controls the effects of acetylcholine on your child’s bladder. Intake of this drug can trigger side effects such as feeling drowsy, vomiting, indigestion, etc. If you have problems in your liver or conditions like asthma or bronchitis, you are advised to talk to your doctor prior to taking these drugs. This medication can interact with antihistamines, antiepileptic drugs and a few MAO inhibiting drugs.
Amitriptyline – This drug is prescribed for treating stress, tension and anxiety. It mainly works on the serotonin levels and enhances the availability of such neurotransmitters to your brain. It is often prescribed at a low level of dosage; levels are very slowly enhanced based on the side effects and the changes observed in your medical condition. Common side effects include problems while urinating, dizziness, dehydration, etc. You are advised not to take this drug is you have an extra sensitive thyroid gland (hyperthyroid), respiratory disorders such as bronchitis or a recent event of cardiac unrest. This drug is known for its interactions with a few NSAIDs like naproxen, anticoagulants like warfarin, supplements to boost thyroid levels, etc.
Clomipramine – This drug is used in the treatment of anxiety and other conditions such as obsessive-compulsive disorder, panic disorders, mood swings, etc. It strengthens the amount of organic substances (belonging to a class called neurotransmitters) in your brain and helps ease anxiety and depression. Some adverse side effects of its intake are chills, nausea and inability to pass stools. If you had a recent medical history of a cardiac arrest, you are advised not to take this drug. This drug is capable of interacting with lithium, a few monoamine oxidase inhibiting medications, etc.
These drugs are belong to the earliest class of medications to treat anxiety. Owing to modern developments in treatment methods, such drugs are not so widely used now. However, tetracyclic antidepressants are still used to treat a few people; especially when the other established medications fail to yield required results. These drugs also have an impact on the level of transmitting chemicals in your brain. It controls the nerve cells which convey nervousness to your brain; thus, it yields a calming effect. Mitrazapine and trazodone are few prescribed medications belonging to this class of drugs.
Mirtazapine – It is used in the treatment of anxiety as well as mood swings, including depression. It is also prescribed for stimulating your appetite. If you have a clinical history of renal disorders, hepatic dysfunction or hypertension, you are advised to inform about these conditions to your pharmacist as well as your treating doctor. This drug may interact with a few serotonin norepinephrine reuptake inhibiting drugs such as venlafaxine, dexvenlafaxine, duloxetine, etc. It is also known to interact with selective serotonin reuptake inhibitors such as paroxetine, fluoxetine, etc. Common side effects triggered by intake of mirtazapine include difficulties experienced while passing stools, dehydration risks, nausea, etc.
Trazodone – The usual prescription of this medication is pills with strength of 100 milligrams. However, prescribed doses can vary depending on the treatment plan as well as your medical condition. You are advised to strictly follow the instructions of your treating doctor. It is highly recommended to read all the directions printed on the drug’s label carefully before starting a course. Side effects this drug include vomiting, nausea, headache, etc. If you are taking water pills (diuretics) or experiencing higher blood pressure, you need to inform your treating doctor. This drug may interact with macrolide antibiotics such as erythromycin, antifungal drugs like ketoconazole, a few antiepileptic medications and monoamine oxidase (MAO) inhibiting pills.
Monoamine oxidase inhibitors
These are the first generation, antidepressant medications introduced to handle anxiety and related stresses. Though other classes of drugs have broadly replaced these medications, they are prescribed when other modes yield limited results.
In general, intake of MAOI drugs requires keeping away from a few specific drugs, mainly to avoid hypertension and associated risks. There are a few diet-based restrictions as MAOI drugs can interact with some foods you may be consuming regularly.
Monoamine oxidase is an enzyme; this displays a key role in draining transmitting chemicals such as dopamine, serotonin, norepinephrine, etc. from your brain. As the name suggest, these drugs help avoid this draining process and thus enable increased access of these chemicals to your brain. A few of the commonly prescribed monoamine oxidase inhibiting drugs are selegiline, isocarboxazid, phenelzine, tranylcypromine, etc.
Selegiline – This drug is used in the case management of anxiety, mental conditions such as Parkinson’s disease, etc. It strengthens the presence of neuro-transmitting substances like dopamine, serotonin, etc. in your brain. It is also prescribed to treat muscular stiffness, tremors and spasms.
If you are diabetic or hypertensive, you need to be careful while taking this drug. Some of its adverse side effects are swelling of toes, abdominal cramps, nausea, etc. It may interact with drugs used for the treatment of migraines and those prescribed to treat attention deficit syndrome.
Other anti-anxiety medications
Apart from the above, drugs commonly prescribed for treating anxiety are buspirone, buproprion, barbiturates, carbamates, opioids, alcohol, etc.
Buspirone – This drug is commonly prescribed at a dosage of 10 milligrams. It is prescribed for the treatment of anxiety (commonly used for the generalized genre of anxieties). It is however administered for short term purposes only. Main action of this medication is to alter the mix of transmitters in your brain and thus decrease restlessness or anxiety. Its common side effects are insomnia (also, other sleep related disorders), inability to focus on things, nausea, etc. If you have liver problems, you are advised not to take this pill. It may interact with other medications – for example, with antibiotics like erythromycin as well as alcohol.
Bupropion – This medication is used for treating mood swings which can make way for anxieties and apathy. This enhances the neurotransmitter footprint of your brain and helps reduce anxiety levels. You are advised to talk to your treating doctor – prior to starting a course of this drug – if you have kidney problems, cardiac ailments or high blood sugar (and a few other symptoms of diabetes). Inform your doctor about all other drugs you may be currently consuming; especially, a few antibiotics (such as linezolid, etc.) or medications to treat angina, chest pain or hypertension.
In sum, there is a wide range of medications available to treat anxiety and associated disorders. They fall under multiple categories. Some of the salient categories of anxiety medicines are selective serotonin reuptake inhibiting drugs (SSRIs), serotonin norepinephrine reuptake inhibiting medications (SNRIs), monoamine oxidase inhibiting (MOAI) medicines, tricyclic antidepressants, tetracyclic antidepressants, etc.
Other classes of anxiety medicines are benzodiazepines, barbiturates, carbamates, opioids, alcohol, and a few miscellaneous drugs such as buspirone, bupropion, etc. Almost all of these medicines are made available only as prescription medicines. The main reason is their ability to form habits, and over a period of time can make you addicted to them. Misuse of medicines to treat anxiety may lead to near-fatal as well as fatal outcomes. You are hence advised to buy anxiety medications with prescriptions from a qualified medical practitioner.