Anxiety is the most common mental illness affecting Americans today with one-in-eight people suffering from some kind of anxiety disorder in their lifetime. Anxiety disorder treatment often requires a combination approach: Therapy and anxiety medications.
Anxiety medications can help control anxiety both in the long and short term. Some anxiety drugs are indicated for acute anxiety while others help anxiety disorders overall. Antidepressants, benzodiazepines, beta-blockers and antipsychotics can all be used as anti-anxiety medication. (complete list of anxiety medications)
One medication, Buspirone (BuSpar), is known specifically as an antianxiety drug. It is sometimes considered an antidepressant but is really unrelated to other classes of drugs. Buspirone (BuSpar) is taken long-term and takes 2-3 weeks to take effect.
Selective Serotonin Reuptake Inhibitors – SSRIs for Anxiety
The usual antianxiety drug of choice is from a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). While these medications are, primarily, antidepressants, many have been shown as effective drugs for anxiety as well. Medications that work on the brain chemical, norepinephrine, as well as serotonin are also used as drugs for anxiety.
SSRIs are nonaddictive medications and are generally taken long-term. An anti-anxiety effect from SSRIs is usually seen in 2-4 weeks depending on how fast the dosage is increased. SSRIs for anxiety are known to be helpful for:
- Generalized anxiety disorder (GAL)
- Panic disorder
- Obsessive-compulsive disorder (OCD)
- Social phobia
Older antidepressants such as tricyclic antidepressants and monoamine oxidase inhibitors can also be used as antianxiety medication but due to their increased risk of side effects, they are not considered a first choice.
Benzodiazepines for Anxiety
Benzodiazepines are common antianxiety medications that are primarily taken short-term. Usage of this type of antianxiety drug is generally confined to six weeks or less or is used to treat acute episodes like panic attacks. Benzodiazepines (often just known as benzos) are often used in addition to other antianxiety medication like an SSRI.
Some people on benzodiazepines run the risk of dependence, abuse and withdrawal so any time benzos are prescribed, their use should be carefully monitored. Because of this risk, benzodiazepines are not recommended for use in those who have previously had drug or alcohol use issues.
Benzodiazepines can be used to treat virtually any type of anxiety including:
- Panic attacks
- Situational anxiety
- Adjustment disorder
Antipsychotic Anxiety Medication
While the name "antipsychotic" suggests the drug is used to treat psychosis, antipsychotics are used in many other ways as well and taking one does not indicate the presence of psychosis. Antipsychotics are often used to improve the effectiveness of other anxiety medication. Antipsychotics may also be used on their own, but are considered a second choice antianxiety medication.
Antipsychotics are long-term treatment options mostly used in the treatment of generalized anxiety disorder. Both older and newer, known as typical and atypical, antipsychotics can be used as anxiety drugs but the older, typical antipsychotics have a greater likelihood of side effects.
All antipsychotics run the possibly life-threatening risk of:
- Neuroleptic malignant syndrome
- Muscle movement disorders such as acute dystonias and tardive dyskinesia
- Weight gain
- Metabolic syndrome
- Potential to cause diabetic ketoacidosis as well as stroke, hypertension, hypotension, or sudden death from cardiac conduction or cardiac electrophysiological abnormalities
Blood Pressure Drugs Including Beta-Blockers for Anxiety
This type of drug is known as an antihypertensive agent. In other words, these are drugs designed to decrease blood pressure. Antihypertensives may have a positive effect on the physiological effects of anxiety. These antianxiety drugs are designed to be taken at the time of anxiety but their effect may be felt for up to one week afterwards. Beta-blockers also belong in this class of medication and several beta-blockers for anxiety have been shown useful.
Drugs in this class are mostly considered investigational in the area of anxiety. However, studies have shown that beta-blockers may be useful in situational / performance anxiety as well as post-traumatic stress disorder.
Anticonvulsant Anxiety Medications
Anticonvulsants are sometimes prescribed off-label as anxiety medications. This may be due to their ability to increase a chemical in the brain known as gamma-aminobutyric acid (GABA). GABA tends to calm the central nervous system which is helpful in those with anxiety.