Anxiety is a natural behavior that humans experience in response to any physical or psychological threat. And, it becomes a problem when this reaction is too excessive in relation to the thing that triggers it. Also, it can result in a pathological state of anxiety that may require the use of anti-anxiety medications.
Additionally, there is no clear boundary between normal anxiety and a pathological problem. But, one could say it’s at the point at which your symptoms begin to interfere with your daily life.
Anxiety is a mental disorder that is more and more common around the world. For example, the number of people suffering from depression and anxiety increased from 416 to 615 million, between 1990 and 2013.
So, to understand why some medications are more appropriate than others, it’s important to differentiate between the types of anxiety:
- Some anxiety involves fear, such as panic attacks, social anxiety, and phobias.
- Other anxiety is more general in nature, without any clear cause or origin.
Treatment for anxietyFirst, anxiolytic anti-anxiety medications relieve or suppress the symptoms of anxiety without having sedative effects or putting the patient to sleep. On the other hand, Benzodiazepine is the ideal anti-anxiety medication because while it can cause sedation at higher doses, it’s possible to manage anxiety effectively and with low risk to the patient.
However, this class of anti-anxiety medications has the disadvantage of producing well-known adverse effects, such as amnesia, dependence, and high physical tolerance.
Additionally, medication must also be combined with a psychological approach to treatment. Also, in the last decade, anti-anxiety medications and treatments have shifted from being based on traditional hypnotic or anti-anxiety medications to a wide variety of drugs. And, these drugs are used for other disorders of the central nervous system.
The first benzodiazepine was chlordiazepoxide, synthesized in 1961. And, this class of medication acts by selectively binding to GABA receptors. Additionally, this neurotransmitter mediates the inhibition of the central nervous system. Therefore, benzodiazepines facilitate the opening of chlorine channels activated by GABA and accentuate their inhibitory effects. Also, they are mildly sedative, relax the muscles, and have anticonvulsant effects.
What’s more, Benzodiazepines are frequently used to treat acute anxiety. Basically, they have been effective against panic attacks and have even been used as enemas for epileptic children. And, they can be classified by the time that it takes for their effects to be felt:
- Short-acting benzodiazepines: midazolam, triazolam
- Intermediate-acting: alprazolam, bromazepam, lorazepam, lormetazepam
- Long-acting: clobazam, clorazepate, diazepam, chlordiazepoxide
What’s more, the body easily absorbs these medications. However, the anti-anxiety medications can interact with psychotropic drugs, alcohol, barbiturates, opiates, and anti-allergenic drugs. And, for elderly people, the dose should be carefully selected to avoid accumulation in the body.
The administration of lorazepam, oxzepam, and temazepam is recommended for older people.
The man side effects of these anti-anxiety medications are:
- Loss of coordination
In addition, all benzodiazepines can lead to higher tolerance (a gradual increase in the dose required to produce the same effect) and dependence. So, this is why it’s recommended to gradually reduce a patient’s dose of benzodiazepines when trying to stop treatment.Also, an acute overdose of benzodiazepine is considerably less dangerous than that of other anti-anxiety medications. However, it can lead to severely slowed breathing. In this situation, flumazenil is more typical. Doctors use it to help reverse the same effects in the case of alcohol poisoning.
Buspirone is an anti-anxiety drug among the class of serotonin 5-HT1a receptors. Also, it can help treat generalized anxiety disorder, but not phobias or social anxiety. And, it does not have sedative, anticonvulsant, or muscle relaxing effects. Additionally, it has few drug interactions. Its main side effects are nausea, dizziness, headache, and restlessness.
Anti-depressants for anxiety
These anti-anxiety medications are effective against generalized anxiety disorder, social anxiety, and phobias. Also, tricyclic anti-depressants and monoamine oxidase inhibitors (MAOIs) have more side effects, but can also be used.
Additionally, in this class of drugs, the following commonly treat anxiety:
- Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine or sertraline
- And, serotonin reuptake inhibitors and noradrenaline, such as venlafaxine or duloxetine
Additionally, anti-epileptic drugs such as gabapentin, pregabalin, valproate, and levetiracetam are also effective for treating generalized anxiety disorder.
And, some atypical anti-psychotics like olanzapine, risperidone, quetiapine, and ziprasidone are effective for treating certain forms of anxiety, including generalized anxiety disorder and post-traumatic stress disorder.
Lastly, Propranolol is widely used to treat certain forms of anxiety. In particular, it’s useful for physical symptoms like sweating, tremors, and high pulse.