Many times, people will try medication to control anxiety before starting therapy. When a person has a panic attack, he or she might go to the emergency room or to a family doctor and get a prescription. This is often because many of the symptoms of anxiety (racing heart, trouble breathing, nausea or teeth grinding) can be mistaken for physical problems.
If a doctor discovers that it is anxiety that is causing the person’s issues, he or she may prescribe one of several drugs to help with the symptoms.
How Do You Know If You Should Be Using Medication?
Are you having panic attacks a few times a week or more?
Are you able to push aside your worry to focus on a task or do you find that you can’t draw your attention away from your worry?
Do you often feel so sick to your stomach with worry that it affects how you eat or sleep?
Do you quickly get red in the face, have shaky legs, stutter or have a racing heart even at the thought that someone might notice your anxiety?
Do you ever feel so terrified of being in a public place that you refuse to go?
What Do Medications Do for Your Brain?
Medications change the way neurotransmitters work. Neurotransmitters are chemicals in your brain. The most common kinds of drugs that work on these chemicals are called SSRIs, Benzodiazepines, and Azapirones.
Selective Serotonin Reuptake Inhibitors (SSRIs)
When your brain is low in serotonin, you may be more negative than most, have trouble concentrating, find it hard to stop worry or panic, or have trouble seeing good solutions to problems. SSRIs help you manage your thoughts and your mood. This makes your brain more effective and can help you learn to deal with your anxiety faster. SSRIs are not addictive. They simply help your brain make more serotonin. The most common SSRIs are:
Prozac
Zoloft
Paxil
Luvox
Celexa
Lexapro
Another medication called an SNRI (Serotonin and Norepinephrine Reuptake Inhibitor) also works to increase certain chemicals in your brain. These drugs include:
Effexor
Cymbalta
Pristiq
It’s important to keep in mind that when a medication is non-addictive, it may take several weeks before it starts helping your brain make those chemicals and even longer for your brain to maintain those chemicals. You should often expect to be on a medication for several months to a year.
Benzodiazepines
Benzodiazepines can be addictive. If you have a history of drug or alchol use, please be careful with these medications. Benzodiazepines help by decreasing the feelings of panic and anxiety. They are often suggested along with SSRIs. Benzodiazepines should not be stopped without the okay from your doctor as there can be withdrawal symptoms. Withdrawal symptoms are unpleasant feelings that occur when a drug is stopped suddenly or too quickly. The most common benzodiazepines include:
Xanax
Ativan
Klonopin
Benzodiazepines work on the chemical GABA, which slows down the firing between your brain cells. Calming effects of benzodiazepines usually occur within 20 minutes and can last for several hours.
Buspirone
Buspirone, or Buspar, is a different anti-anxiety drug called an Azapirone. Azapirones work on serotonin differently than SSRIs. These drugs also work on Dopamine in your brain by taking the edge off your anxiety. Buspirone does not work right away like other medications. It may be best for people with Generalized Anxiety Disorder.
Other Medications
At times, your doctor may suggest a medication that is used “off-label”. This means that the drug is not sold for the use that your doctor is prescribing it for. Certain heart medications called beta-blockers may be prescribed as needed for reducing rapid heart and flushing skin that can happen with panic or anxiety. There are also some anti-seizure medications that can also help reduce anxiety symptoms.
PLEASE NOTE: Medication will not teach you anxiety management techniques. It can, however, calm you enough to so that you can start learning and using the techniques. Appropriate therapy can help you eliminate your anxiety symptoms without medication but there are times when medication is an important aid to feeling better.
If you have questions about whether or not you should be on medication for your anxiety, talk with your family doctor. He or she may recommend you start therapy. Please contact me via email at:
eglcsw@eileengrudierlcsw.com
REFERENCES
Wehrenberg, M. (2008) The 10 Best-Ever Anxiety Management Techniques. New York: W.W. Norton and Company Inc.