Suggestions for Anxiety tx?

What medications are used to treat anxiety disorders?

Antidepressants, anti-anxiety medications, and beta-blockers are the most common medications used for anxiety disorders.

• Obsessive compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Generalized anxiety disorder (GAD)
• Panic disorder
• Social phobia.

Antidepressants

Antidepressants were developed to treat depression, but they also help people with anxiety disorders. SSRIs such as fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil), and citalopram (Celexa) are commonly prescribed for panic disorder, OCD, PTSD, and social phobia. The SNRI venlafaxine (Effexor) is commonly used to treat GAD. The antidepressant bupropion (Wellbutrin) is also sometimes used. When treating anxiety disorders, antidepressants generally are started at low doses and increased over time.

Some tricyclic antidepressants work well for anxiety. For example, imipramine (Tofranil) is prescribed for panic disorder and GAD. Clomipramine (Anafranil) is used to treat OCD. Tricyclics are also started at low doses and increased over time.

MAOIs are also used for anxiety disorders. Doctors sometimes prescribe phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan). People who take MAOIs must avoid certain food and medicines that can interact with their medicine and cause dangerous increases in blood pressure. For more information, see the section on medications used to treat depression.

Benzodiazepines (anti-anxiety medications)

• Clonazepam (Klonopin), which is used for social phobia and GAD
• Lorazepam (Ativan), which is used for panic disorder
• Alprazolam (Xanax), which is used for panic disorder and GAD.

Buspirone (Buspar) is an anti-anxiety medication used to treat GAD. Unlike benzodiazepines, however, it takes at least two weeks for buspirone to begin working.

Clonazepam, listed above, is an anticonvulsant medication. See FDA warning on anticonvulsants under the bipolar disorder section.

Beta-blockers

Beta-blockers control some of the physical symptoms of anxiety, such as trembling and sweating. Propranolol (Inderal) is a beta-blocker usually used to treat heart conditions and high blood pressure. The medicine also helps people who have physical problems related to anxiety. For example, when a person with social phobia must face a stressful situation, such as giving a speech, or attending an important meeting, a doctor may prescribe a beta-blocker. Taking the medicine for a short period of time can help the person keep physical symptoms under control.

What are the side effects?

• Upset stomach
• Blurred vision
• Headache
• Confusion
• Grogginess
• Nightmares.

• Dizziness
• Headaches
• Nausea
• Nervousness
• Lightheadedness
• Excitement
• Trouble sleeping.

• Fatigue
• Cold hands
• Dizziness
• Weakness.

In addition, beta-blockers generally are not recommended for people with asthma or diabetes because they may worsen symptoms.

How should medications for anxiety disorders be taken?

People can build a tolerance to benzodiazepines if they are taken over a long period of time and may need higher and higher doses to get the same effect. Some people may become dependent on them. To avoid these problems, doctors usually prescribe the medication for short periods, a practice that is especially helpful for people who have substance abuse problems or who become dependent on medication easily. If people suddenly stop taking benzodiazepines, they may get withdrawal symptoms, or their anxiety may return. Therefore, they should be tapered off slowly.

Buspirone and beta-blockers are similar. They are usually taken on a short-term basis for anxiety. Both should be tapered off slowly. Talk to the doctor before stopping any anti-anxiety medication.

http://www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml

Lorazepam was helpful for me too, and didn't seem to affect my weight.  I have had GAD for years, and over time, exercise, meds and getting plenty of rest seem to be most helpful with major anxiety, but nothing will completely get rid of it.  I've learned to live with whatever is left over.  Best of luck!

leaf,

Beta-blockers are kind of like some anti-depressants: they can act against anxiety, but they also can cause it. I never had anxiety in my life until I started taking beta-blockers for my thyroid.

Yes, many medications, especially those used for psychological conditions, can have opposite effect in some people.  We are all individual.  Your experience is very valid for you.

I have had patients call me (I'm a hospital pharmacist on the graveyard shift) and was told never to dispense Dilaudid again because they made the caller have more pain.  (Dilaudid is an opiate commonly used for post-operation and other pain.)  I do not doubt that Dilaudid caused them more pain.  However, for many people, Dilaudid does help ease pain.

When my friend was in pharmacy school, they had a double blind placebo controlled experiment on normal volunteer students: some got Seconal (a powerful sedative), some got Ritalin (a powerful stimulant) both in therapeutic doses usually used in sleep or to keep people alert (respectively), and some got placebo.  Everyone in the class had to guess which  drug each volunteer  got. (They were also able to do things like measure pulse, etc.)  They guessed wrong more often than they got it right (particularly the volunteers themselves.)

Some soldiers who were hooked on very pure heroin in the Vietnam War went back home to the US and did not undergo withdrawal. 

Some people can have opposite effects than one that is intended.  For most people, dipenhydramine (Benadryl) makes them sleepy, but for some it makes them more wired.  Most people who take pseudoephedrine (Sudafed) get, if anything, wired, but for some it makes them sleepy.

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Expectations and specific surroundings and support can have a significant effect on one's psychological and physical self.  And there are a lot of other effects we do not understand.

Most non-observational studies report results with statistics for groups of people.    Your experience is true for you, others may have the same experience, and other people may have other experiences.  Everyone can react differently, just as some people do fine with tamoxifen, and for others it turns their life into a nightmare. We are all individuals.

I have a cyst in the non cancer breast. I will always worry about breast cancer in the other boob. This stinks!