Anti-Anxiety Medication

The best treatment for anxiety is a combination of relaxation techniques and cognitive therapy. Medications are second-line treatments for anxiety. In this page you'll learn about the drugs that are commonly used to treat anxiety and panic attacks, the problems associated with them, and some alternatives.

Benzodiazepines and Related Drugs

Anti-anxiety medications are also called tranquilizers and sleeping pills. The most common anti-anxiety medications are benzodiazepines (benzos) like Valium and its relatives. Recently a new class of drugs has been developed that are strictly speaking non-benzodiazepines, but they have the same side effects and risks.

These are some of the common tranquilizers and sleeping pills, and their generic names.

Benzodiazepines Used to Treat Anxiety

• Valium (diazepam)
• Ativan (lorazepam)
• Xanax (alprazolam)
• Klonopin or Rivotril (clonazepam)
• Restoril (temazepam)
• Rohypnol (flunitrazepam)
• Dalmane (flurazepam)

Benzodiazepine-Mimics (Z-drugs)

• Imovane (zopiclone)
• Ambien (zoldipem)
• Lunesta (eszopiclone)

Benzodiazepine-mimics (also called z-drugs) were initially marketed as non-addictive tranquilizers because they were chemically different than benzodiazepines. But subsequent research has shown that these drugs act on the same GABA neuroreceptor as benzodiazepines, and clinical experience has shown that benzodiazepine-mimics are also addictive.

Serotonergic Medication Used to Treat Anxiety

• Buspirone (Buspar)

Buspirone is a serotonergic medication like some antidepressants, but it is only used for treating anxiety. It must be taken for several weeks for it to be fully effective.

Side-Effects of Benzodiazepines

1) All tranquilizers are potentially addictive. If you take them for longer than a month, you will probably develop some dependence on them, and you will probably experience some withdrawal when you stop using them.

2) Long-term use of tranquilizers increases your anxiety.[1] If you use tranquilizers for longer than a month, they can increase your anxiety and disturb your sleep. The irony is that tranquilizers are prescribed to help your anxiety and sleep. This is what makes them the perfect addictive drugs. The longer you use them, the more you need them.

3) Tranquilizers are brain depressants. If you take them for longer than a month, they can increase your chances of becoming depressed.

4) Tranquilizers block the effectiveness of antidepressants. If you take them for more than a month, any antidepressants you're taking will be less effective, and you may feel more depressed or anxious.

Check with your doctor to make sure there are no other medical causes for your anxiety. For example, you should have your thyroid checked. If there are no other medical causes for your anxiety, and you cannot control your anxiety with relaxation techniques and cognitive therapy, then you might want to discuss the possibility of an antidepressant with your doctor.

Why are tranquilizers still prescribed? They can be helpful for short-term anxiety or sleeplessness. Some people need them to deal with unusually stressful situations. But if you take them for longer than a month, your body will adapt to them, your anxiety level may rise, and you may need more of them over time.

Antidepressants as Alternatives to Benzodiazepines

If your anxiety is so severe that you need medication, antidepressants are usually a better choice than tranquilizers. Anxiety and depression often coexist. But even if you’re not depressed, antidepressants are usually a better choice for treating anxiety than benzodiazepines.

Other Medication

Antipsychotic medication is sometimes used to relieve the symptoms of anxiety, in serious cases. This is because antipsychotic medication is sedating besides being antipsychotic. However, antipsychotic medication can have permanent neurological consequences if taken for more than a few years, such as tremors, akathisia, parkinsonism, and tardive dyskinesia.

The most common antipsychotic medication that is used to treat anxiety in the short-term is Seroquel (quetiapine).

References

1) D Poyares, C Guilleminault, MM Ohayon, S Tufik, "Chronic benzodiazepine usage and withdrawal in insomnia patients," Journal Psychiatric Research (2004) May-Jun;38(3):327-34.