The role of medication in anxiety treatment
When you’re overwhelmed by heart-pounding panic, paralyzed by fear, or exhausted from yet another sleepless night spent worrying, you’ll do just about anything to get relief. And there’s no question that when anxiety is disabling, medication may help. But are drugs always the best answer?
Many different types of medications are used in the treatment of anxiety disorders, including traditional anti-anxiety drugs such as benzodiazepines (typically prescribed for short-term use) and newer options like SSRI antidepressants (often recommended as a long-term anxiety solution). These drugs can provide temporary relief, but they also come with side effects and safety concerns—some significant.
They are also not a cure. In fact, there are many questions about their long-term effectiveness. According to the American Academy of Family Physicians, benzodiazepines lose their therapeutic anti-anxiety effect after 4 to 6 months of regular use. And a recent analysis reported in JAMA Psychiatry found that the effectiveness of SSRIs in treating anxiety has been overestimated, and in some cases is no better than placebo.
What’s more, it can be very difficult to get off anxiety medications without difficult withdrawals, including rebound anxiety that can be worse than your original problem.
Benzodiazepines for anxiety
Benzodiazepines (also known as tranquilizers) are the most widely prescribed type of medication for anxiety. Drugs such as Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), and Ativan (lorazepam) work quickly, typically bringing relief within 30 minutes to an hour. That makes them very effective when taken during a panic attack or another overwhelming anxiety episode. However, they are physically addictive and not recommended for long-term treatment.
Benzodiazepines work by slowing down the nervous system, helping you relax both physically and mentally. But it can also lead to unwanted side effects. The higher the dose, the more intense these side effects typically are—although some people feel sleepy, foggy, and uncoordinated even on low doses. This can cause problems with work, school, or everyday activities such as driving. The medication hangover can last into the next day.
Common side effects of benzodiazepines include:
- Poor balance or coordination
- Slurred speech
- Trouble concentrating
- Memory problems
- Stomach upset
- Blurred vision
Benzodiazepine safety concerns
Benzodiazepines are generally not recommended for long-term use since the safety concerns and risk of abuse increase as you build up a tolerance to the medication.
Drug dependence and withdrawal
When taken regularly, benzodiazepines lead to physical dependence and tolerance, with increasingly larger doses needed to get the same anxiety relief as before. This happens quickly—usually within a couple of months, but sometimes in as little as a few weeks.
- If you abruptly stop taking your medication, you may experience severe withdrawal symptoms such as:
- Increased anxiety, restlessness, shaking.
- Insomnia, confusion, stomach pain.
- Depression, confusion, panic attacks.
- Pounding heart, sweating, and in severe cases, seizure.
Many people mistake withdrawal symptoms for a return of their original anxiety condition, making them think they need to restart the medication. Gradually tapering off the drug will help minimize the withdrawal reaction.
Drug interactions and overdose
While benzodiazepines are relatively safe when taken only occasionally and in small doses, they can be dangerous and even deadly when combined with other central nervous system depressants. Always talk to your doctor or pharmacist before combining medications.
Don’t drink on benzodiazepines. When mixed with alcohol, benzodiazepines can lead to fatal overdose.
Don’t mix with painkillers or sleeping pills. Taking benzodiazepines with prescription pain or sleeping pills can also lead to fatal overdose.
Antihistamines amplify their effects. Antihistamines—found in many over-the-counter sleep, cold, and allergy medicines—are sedating on their own. Be cautious when mixing with benzodiazepines to avoid over-sedation.
Be cautious when combining with antidepressants. SSRIs such as Prozac and Zoloft can heighten benzodiazepine toxicity. You may need to adjust your dose accordingly.
Credited to : HelpGuide