This is the second post in a series in which I’m aiming to demystify some of the very basics of psychotropic medications. Make sure you read the first post to get some of the background before reading this post about anxiety medications. And remember that I’m not a physician and in no way claim to be an expert on medications, so this educational information should not be interpreted in any way as clinical advice of any kind whatsoever. Talk to your prescriber about medications before making any changes — it can be very dangerous to change or stop your medications on your own.
Antidepressants
Contrary to the way the medications are named, anxiety disorders are usually treated with antidepressant medications. Antidepressants directly affect anxiety, plus they’re not habit-forming (or “addictive”), and they don’t have as many side effects as the traditional “anxiety medications.” So make sure you check out the post about antidepressants because chances are that if you’re prescribed a medication for anxiety, it’s probably actually an antidepressant.
For example, OCD is often treated with clomipramine (Anafranil), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft). For Generalized Anxiety Disorder, you’ll commonly see venlafaxine (Effexor), duloxetine (Cymbalta), and escitalopram (Lexapro) prescribed. And Social Anxiety Disorder, Generalized Anxiety Disorder, and Panic Disorder are commonly treated with paroxetine (Paxil), while Panic Disorder and PTSD can be treated with sertraline (Zoloft).
“The withdrawal from these medications is tricky because it feels a lot like anxiety, which makes people think their anxiety is ‘bad’ and they need the medication to manage it. “
Benzodiazepines
Apart from using antidepressants to manage anxiety, there are actual “anxiety medications.” The most common are benzodiazepines. These medications include
- Clonazepam (Klonopin)
- Alprazolam (Xanax)
- Diazepam (Valium)
- Lorazepam (Ativan)
The side effects are no joke — drowsiness, slow motor coordination, and sometimes confusion or fatigue. They’re also habit-forming, meaning people can become dependent on them, and can cause withdrawal symptoms when they’re reduced or discontinued. For that reason, they aren’t really prescribed anymore for long-term treatment. The withdrawal from these medications is tricky because if you stop taking them, the withdrawal feels a lot like anxiety, which makes people think their anxiety is “bad” and they need the medication to manage it. The withdrawal symptoms include
- Anxiety
- Shakiness
- Headaches
- Dizziness
- Insomnia
- Decreased appetite
- Seizures
Other Medications
There are also a few other anxiety medications to know about, including buspirone (Buspar). It’s completely unrelated to benzodiazepines and doesn’t have the same risk of dependence and withdrawal that benzos do, so it’s safer and more commonly prescribed.
Beta blockers (like propranolol) are a class of medication that were originally used to treat high blood pressure and some heart conditions, and they’re still used for that purpose sometimes. It’s also been discovered that they’re useful for treating anxiety. They work by blocking adrenaline (and a similar chemical called noradrenaline) from going to its targets, which then affects your fight-or-flight response and helps manage the physical symptoms of anxiety.
Gabapentin is another strange medication that was originally developed for another purpose (controlling seizures and nerve pain) but is now sometimes prescribed for anxiety.
Final Thoughts
While medications are super helpful for managing anxiety, I also have to mention a bit of a disclaimer. Especially short-acting drugs (like benzodiazepines) can work against you in your long-term recovery. When you take a medication like that and it almost immediately takes away your anxiety, that seems like a good thing. But actually it makes you dependent on the medication as a coping skill to make that anxiety go away. Forever. There are other strategies that can help with that acute fear-related anxiety that offer a long-term solution. Cognitive-behavioral therapy, and especially therapies that help expose you to the things that make you anxious (in a very controlled and supportive way) and then desensitize you to that anxiety, have a ton of support for long-term maintenance of anxiety. So anxiety medications like the ones mentioned on this page are really useful for brief, infrequent anxiety, but if you’re dealing with a more chronic or longer-term issue, talk to your physician about a different approach.
Other post in this series:
Make sure you subscribe so you don’t miss out on upcoming posts in this series:
- Mood Stabilizers
- Antipsychotics (check out this one — they’re used commonly these days for all kinds of mental health conditions)
Source: Patzer, D. Overview of Psychopharmacology. Magellan Health.
Hayden C. Finch, PhD, is a practicing psychologist in Des Moines, Iowa, who is focused on helping you master your mental health.
