I consulted Justine Kent, MD, for the latest information about treating anxiety disorders with medications. Dr. Kent is an Adjunct Assistant Professor of Psychiatry at Columbia University’s College of Physicians & Surgeons. Read on to learn what she had to say.
Medication treatment of anxiety is generally safe and effective. But it often takes time and patience to find the drug that works best for you.
The first line of treatment for an anxiety disorder is often cognitive-behavioral therapy, or CBT, a well-established, highly effective, and lasting treatment. But some people find that excessively high levels of anxiety make them unable to get the most out of such treatment. In this case, medication may help overall levels of anxiety and allow full participation in CBT.
Depression often complicates chronic anxiety. Don’t ignore the depressive symptoms of a sad mood, bouts of tearfulness, low self-esteem, and feelings of guilt or hopelessness. Medication often helps alleviate those symptoms and reduce those of anxiety, too. Most drugs doctors prescribe to treat anxiety come from the antidepressant class of medication, so they can be used to treat both conditions effectively.
Types of Medications
Four major classes of medications are used to treat anxiety disorders.
- SSRIs (selective serotonin reuptake inhibitors) relieve symptoms by blocking the reabsorption, or reuptake, of serotonin by certain nerve cells in the brain. This leaves more serotonin available, which enhances neurotransmission (the sending of nerve impulses) and improves mood. SSRIs are “selective” because they affect only serotonin and not other neurotransmitters. Generic names: citalopram, escitalopram, fluoxetine, paroxetine, sertraline
- SNRIs (serotonin-norepinephrine reuptake inhibitors) increase the levels of the neurotransmitters serotonin and norepinephrine by inhibiting their reabsorption into cells in the brain. Generic names: venlafaxine, duloxetine
- Tricyclic antidepressants inhibit the reabsorption of the neurotransmitters serotonin and norepinephrine. They have been increasingly replaced by SSRIs. Generic names: amitriptyline, imipramine, nortriptyline
- Benzodiazepines promote relaxation and reducing muscular tension and other physical symptoms of anxiety. Frequently used for short-term management of anxiety, such as for minor medical procedures. Generic names: alprazolam, clonazepam, diazepam, lorazepam
Other types of medication may also be used to treat anxiety disorders, including MAOI's (monoamine oxidase inhibitors), anticonvulsants, beta blockers, and atypical antipsychotics (also known as second-generation antipsychotics). Talk to your physician about the best treatment for you.
If you experience a side effect of any medication, contact your physician. Do not stop taking a medication abruptly because it may create other health risks.