What You Need to Know About Anti-Anxiety Medications
"Below is an article we found on the web that we feel gives some terrific and important information concerning a class of drugs that are used quite often to treat some of the symptoms of PTSD.
Our feeling is that YOU MUST educate yourself on your medications and by doing so you not only become active in your own care but educated in your medication managment if you choose that route. Please know if you are a recovering alcoholic or suffer from any type of addiction issue you MUST think about how these drugs can or will effect you!
We can not emphasis how important being educated about your own treatment and medications is for you to be able to heal."
We are NOT doctors nor are we recommending anyone stop or start any type of medication unless you consult with your doctor.
Did You Know" Medication can relieve some of the symptoms of anxiety, but it doesn’t cure the underlying problem and it’s usually not a long-term solution. Anxiety medications also come with side effects and safety concerns, such as the risk of addiction. In order to decide whether medication is right for you, it’s important to weigh the drug benefits against the drawbacks. Once you’ve researched your options, including other therapies and lifestyle changes that may help, you can make an informed decision.
Understanding anxiety medication
Many different types of medications are used in the treatment of anxiety disorders, including traditional anti-anxiety drugs such as benzodiazepines, and newer options like antidepressants and beta-blockers. These medications can be very effective, but they shouldn’t be thought of as a cure. Anxiety medication can provide temporary relief, but it doesn’t treat the underlying cause of the anxiety disorder.Once you stop taking the drug, the anxiety symptoms often return in full force.
It’s important to be aware of the risks of anxiety medication, too.
Anxiety medication can cause a wide range of unpleasant and sometimes dangerous side effects. Many medications for anxiety are also habit forming and physically addictive, making it difficult to stop taking them once you’ve started. The bottom line is that anxiety medications can be helpful, but they’re not right for everyone and they’re not the only answer.
Exploring your anxiety treatment options
There are many treatment alternatives to medication, including cognitive-behavioral therapy, which is widely accepted to be the most effective treatment for anxiety. To overcome anxiety for good, you may also need to make major changes in your life. Lifestyle changes that can make a difference in anxiety levels include regular exercise, adequate sleep, and a healthy diet. Other effective treatments for anxiety include talk therapy, meditation, biofeedback, hypnosis, and acupuncture.
The advantage of non-drug treatments for anxiety is that they produce lasting changes and long-term relief. If your anxiety is so severe that it interferes with therapy, medication may be useful in the short-term to get your symptoms under control. Once your anxiety is at a manageable level, other forms of behavior and talk therapy can be successfully pursued.
Self-help tips for conquering anxiety Medication and therapy aren’t the only options for anxiety relief. There are many self-help strategies you can use to get the best of worry and fear.
Anti-anxiety drugs (tranquilizers, benzodiazepines) Anti-anxiety drugs, also known as tranquilizers, are medications that relieve anxiety by slowing down the central nervous system. Their relaxing and calming effects have made them very popular: anti-anxiety drugs are the most widely prescribed type of medication for anxiety. They are also prescribed as sleeping pills and muscle relaxants.Benzodiazepines are the most common and ADDICTIVE class of anti-anxiety drugs. They include:
- Xanax (alprazolam)
- Klonopin (clonazepam)
- Valium (diazepam)
- Ativan (lorazepam)
Benzodiazepines are fast acting—typically bringing relief within thirty minutes to an hour. Because they work quickly, benzodiazepines are very effective when taken during a panic attack or another overwhelming anxiety episode. But despite their potent anti-anxiety effects, they have their drawbacks.
Side effects of anti-anxiety drugs
Anti-anxiety drugs like benzodiazepines work by reducing brain activity. Understandably, this leads to side effects beyond anxiety relief. The higher the dose, the more pronounced these side effects typically are. But some people feel sleepy, foggy, and uncoordinated even on low doses of benzodiazepines, which can cause problems with work, school, or everyday activities such as driving. Some even feel a medication hangover the next day.Because benzodiazepines are metabolized slowly, the medication can build up in the body when used over longer periods of time.
The result is oversedation. People who are oversedated may look like they’re drunk. Common side-effects of benzodiazepines or tranquilizers
- Drowsiness, lack of energy
- Clumsiness, slow reflexes
- Slurred speech
- Confusion and disorientation
- Dizziness, lightheadedness
- Impaired thinking and judgement
- Memory loss, forgetfulness
- Nausea, stomach upset
- Blurred or double vision
Benzodiazepines are also associated with depression. Long-term benzodiazepine users are often depressed, and higher doses are believed to increase the risk of both depressive symptoms and suicidal thoughts and feelings. Furthermore, benzodiazepines can cause emotional blunting or numbness. The medication relieves the anxiety, but it also blocks feelings of pleasure or pain. Paradoxical effects of anti-anxiety drugsDespite their sedating properties, some people who take anti-anxiety medication experience paradoxical excitement. The most common paradoxical reactions are increased anxiety, irritability, and agitation. However, more severe effects can also occur, including:
- Hostility and rage
- Aggressive or impulsive behavior
While rare, these adverse effects are dangerous. Paradoxical reactions to these anxiety medications are most common in children, the elderly, and people with developmental disabilities.
Anti-anxiety medication safety concerns
The connection between anxiety medication and accidentsAnti-anxiety medication causes drowsiness and poor coordination, which contributes to accidents at home, at work, and on the road. Studies show that taking anti-anxiety medication increases your risk of having a serious traffic accident. Beyond the common side effects, medication for anxiety comes with additional risks.
While the tranquilizing anti-anxiety drugs are relatively safe when taken only occasionally and in small doses, they can lead to trouble when combined with other substances or taken over long periods of time. Furthermore, certain people have adverse reactions to them–so they’re not safe for everyone, even when used responsibly.
Drug interactions and overdose Used alone, anti-anxiety medications such as Xanax or Valium rarely cause fatal overdose, even when taken in large doses. But when combined with other central nervous system depressants, the toxic effects of these anxiety medications increase.
Taking anti-anxiety medication with alcohol, prescription painkillers, or sleeping pills can be deadly. Dangerous drug interactions can also occur when anti-anxiety drugs are taken with antihistamines, which are found in many over-the-counter cold and allergy medicines.
Antidepressants such as Prozac and Zoloft can also heighten their toxicity.
Other anti-anxiety drug risk factors Anyone who takes benzodiazepines can experience unpleasant or dangerous side effects. But certain individuals are at a higher risk:
- People over 65. Older adults are more sensitive to the sedating effects of anti-anxiety medication. Even small doses can cause confusion, amnesia, loss of balance, and cognitive impairment that looks like dementia. Anti-anxiety drug use in the elderly is associated with an increased risk of falls, broken hips and legs, and car accidents.
- Pregnant women. Expectant mothers should avoid anti-anxiety drugs. Since these anxiety medications cross the placenta, their use during pregnancy can lead to dependence in the baby. Following birth, the baby will then go through withdrawal, with symptoms such as muscle weakness, irritability, sleep and breathing problems, and trembling. These anxiety drugs are excreted in breast milk, so they should be avoided while breastfeeding, too.
- People with a history of substance abuse. Anyone with a current or former problem with alcohol or drugs should avoid anti-anxiety drugs or use them only with extreme caution. The greatest benefit of benzodiazepines is that they work quickly, but this also makes them addictive. This can quickly lead to their abuse, often in dangerous combination with alcohol or other illicit drugs.
Anti-anxiety drug dependence and withdrawal
Anti-anxiety medications–including popular benzodiazepines such as Xanax, Klonopin, Valium, and Ativan–are meant for short-term use. However, many people take anti-anxiety drugs for long periods of time. This is risky because, when taken regularly, benzodiazepines quickly lead to physical dependence.
Drug tolerance is also common, with increasingly larger doses needed to get the same anxiety relief as before. According to the American Academy of Family Physicians, benzodiazepines lose their therapeutic anti-anxiety effect after 4 to 6 months of regular use.Most people become addicted to their anti-anxiety drug within a couple of months, but problems may arise sooner. For some, drug dependency develops after a few short weeks.
Once you’re physically dependent on an anxiety medication, it’s difficult to stop taking it. The body is used to the medication, so withdrawal symptoms occur if the dose is decreased or discontinued. Psychological dependence can be an issue, too. If you’ve been relying on an anti-anxiety drug to keep your anxiety in check, you may lose confidence in your own abilities to deal with life’s difficulties and start to think you “need” the medication to survive.
You may be dependent on benzodiazepines if:
- You have taken benzodiazepines for four months or longer.
- You rely on your pills to cope.
- You have ever cut down or stopped taking your pills and have felt ill or anxious or experienced unusual symptoms.
- You feel your pills are not having the same effect as when you first started taking them.
- You take an extra pill during a stressful time.
- You tried cutting down or stopped taking your pills and could not sleep a wink.
- You have increased your dose.
- You have increased your alcohol intake.
- The benzodiazepines are interfering with your life in some way (sick days off work, family or relationship problems, difficulty coping, difficulty remembering things).
- You always make sure you never run out of your pills.
- You carry your pills with you “just in case.”
If you’re physically dependant on anti-anxiety medication and would like to get off of it, it’s important to slowly decrease your dose. If you abruptly stop taking your medication, you may experience severe withdrawal symptoms such as:
- Increased anxiety
- Pounding heart
Gradually tapering off the drug will help minimize the withdrawal reaction. However, if you’ve taken anti-anxiety medication for a few months, you may still experience some withdrawal symptoms. Anxiety, insomnia, and depression may last for months after you’ve quit. Unfortunately, these persistent withdrawal symptoms are frequently mistaken for a return of the original problem and medication is restarted.
Other types of medications for anxiety Because of the many safety concerns linked to anti-anxiety drugs, other medications for treating anxiety have gained in popularity. The alternatives to the anti-anxiety tranquilizers include antidepressants, buspirone, and beta blockers.
Antidepressant medications for anxiety
Many medications originally approved for the treatment of depression have been found to relieve symptoms of anxiety. These include certain SSRIs, tricyclic antidepressants, MAOIs, and the newer atypical antidepressants. Antidepressants are often preferred over the traditional anti-anxiety drugs because the risk for dependency and abuse is smaller.
However, antidepressants take up to 4 to 6 weeks to begin relieving anxiety symptoms, so they can’t be taken “as needed.” For example, antidepressants wouldn’t help at all if you waited until you were having a panic attack to take them. Their use is limited to chronic anxiety problems that require ongoing treatment. The antidepressants most widely prescribed for anxiety are the SSRIs (selective serotonin reuptake inhibitors).
The SSRIs include drugs such as Prozac, Zoloft, Paxil, Lexapro, and Celexa. The SSRIs have been used to treat panic disorder, obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD).Common side effects are:
- Sexual dysfunction
- Stomach upset
- Weight gain
Although physical dependence is not as quick to develop with antidepressants, withdrawal can still be an issue. If discontinued too quickly, antidepressant withdrawal can trigger symptoms such as extreme depression and fatigue, irritability, anxiety, flu-like symptoms, and insomnia.
Antidepressant suicide risk All antidepressants are required by the FDA to carry a warning about the risk of suicidal thoughts, hostility, and agitation. There is also the risk that antidepressants will cause an increase, rather than a decrease, in depression and anxiety.
To learn more about facts, guidelines and precautions: Antidepressant Medications Buspirone (BuSpar) Buspirone, also known by the brand name BuSpar, is a newer anti-anxiety drug that acts as a mild tranquilizer. Buspirone relieves anxiety by increasing serotonin in the brain–as the SSRIs do–and decreasing dopamine. Compared to traditional anti-anxiety medications like Xanax, buspirone is slow acting. It takes about two weeks to start working on anxiety. However, it has several advantages over the older anti-anxiety drugs: it’s not as sedating, it doesn’t impair memory and coordination, it’s not very addictive, and the withdrawal effects are minimal. Common side effects of buspirone
- Upset stomach
- Dry mouth
Since the risk of dependence is low and it has no serious drug interactions, buspirone is a good option for older individuals and people with a history of substance abuse. However, its effectiveness is limited. It works for generalized anxiety disorder (GAD), but doesn’t seem to help the other types of anxiety disorders.
Beta-blocker medications for anxiety
Beta blockers are a type of medication used to treat high blood pressure and heart problems. However, beta blockers are also prescribed off-label for anxiety. Beta blockers work by blocking the effects of norepinephrine, a stress hormone involved in the fight-or-flight response. This helps control the physical symptoms of anxiety such as rapid heart rate, a trembling voice, sweating, dizziness, and shaky hands. Because beta blockers don’t affect the emotional symptoms of anxiety such as worry, they’re most helpful for phobias, particularly social phobia and performance anxiety.If you’re anticipating a specific anxiety-producing situation (such as giving a speech), taking a beta blocker in advance can help reduce your “nerves.” Beta blockers include drugs such as
Propranolol SotalolTimololPindololLevobunololNadololMetipranolol Common side effects include:
- Unusually slow pulse
Deciding if anxiety medication is right for you
If you’re trying to decide whether or not to treat your anxiety with medication, it’s important to weigh the pros and cons. It’s also important to learn about the common side effects of the anxiety medication you are considering. Side effects of anxiety medication range from mild nuisances such as dry mouth to bigger problems like severe nausea or considerable weight gain. For any anxiety medication, you will have to weigh the side effects against the benefits.
Questions to ask yourself and a mental health professional
- Is medication the best option for my anxiety problem?
- Am I willing to put up with unpleasant side effects in return for anxiety relief?
- What non-drug treatments for anxiety might help?
- Do I have the time and am I willing to pursue non-drug treatments such as cognitive-behavioral therapy?
- What self-help strategies might help me get my anxiety under control?
- If I decide to take anxiety medication, should I pursue other therapy as well?
Questions to ask your doctor
- How will the medication help my anxiety?
- What are the drug's common side effects?
- Are there any food and drinks I will need to avoid?
- How will this drug interact with my other prescriptions?
- How long will I have to take the anxiety medication?
- Will withdrawing from the medication be difficult?
- Will my anxiety return when I stop taking the medication?
If you use medication for anxiety
If you decide to take medication for your anxiety disorder, it is important to learn all you can about your prescription and to take it as directed. The more you know about your anxiety medication, the better equipped you’ll be to identify and deal with side effects, avoid dangerous drug interactions, and minimize other medication risks. If
You're Taking a Benzodiazepine
- Make regular appointments with a psychiatrist who specializes in the treatment of anxiety disorders and who is up on the latest research on benzodiazepines and other anxiety medications and therapies.
- DO NOT discontinue your medication without talking to your psychiatrist first. If you’ve been taking benzodiazepines for over a month, you should gradually reduce your dose under your doctor’s supervision.
- Finding the right dosage is a trial and error process, but you should be concerned if it keeps increasing. If you need higher and higher doses to achieve the same effect, this is a sign of a developing drug dependency.
Some suggestions if you decide to take anxiety medication:
Most Important is to be educated!
- Be patient – It takes time for most anxiety medications to reach their full therapeutic effect. While you may want immediate relief, it’s important to have realistic expectations. You will need to work closely with your doctor to find the right dosage and evaluate the anxiety drug ’s effectiveness.
- Avoid alcohol. Alcohol and anxiety medications don’t mix. The combination can even be lethal. But even in less toxic doses, alcohol and anxiety medication can cause poor coordination and impaired thinking, increasing the risk of motor vehicle accidents and other injuries.
- Monitor your medication response or have someone else – Keep a close eye on your reaction to the anxiety medication, including any physical and emotional changes you’re experiencing. Everyone reacts differently to medications, so it’s impossible to predict what side effects you will have or how well your anxiety drug will work. If you’re taking benzodiazepines (Valium, Xanax, etc.), don’t drive or operate heavy machinery until you know how the drug affects you.
- Talk to your doctor. Be open and honest about side effects your anxiety drug is causing. Don’t be afraid to discuss problems or concerns. And while you should never stop your anxiety medication without talking to your doctor first, ultimately the decision is up to you. If you’re unhappy with how the pills make you feel, ask your doctor to help you taper off.
- Continue therapy – Medication can control the symptoms of anxiety, but it doesn’t treat the underlying problem. Therefore, it’s crucial to pursue therapy or some other form of anxiety treatment. Therapy can help you get to the root of your anxiety problem and develop better coping skills.