Medication for the treatment of Anxiety
The medications used in the treatment for anxiety have changed radically over the last few years. A lot of the treatments that were used caused a number of difficulties including psychological dependence. Psychological dependence is described as the emergence of withdrawal symptoms including anxiety, irritability, anorexia, confusion and nausea. These are also the symptoms of anxiety that the medications are meant to relieve.
These days treatments usually involve either anxiolytics (anti-medication for postpartum depression) or the more modern antidepressant medications. This is understandable as depression and anxiety are closely linked.
In the treatment of anxiety disorders it is important to have an accurate diagnosis of the anxiety disorder being treated as each drug group has different effects.
SSRi’S (Selective serotonin re-uptake inhibitors)
Selective serotonin re-uptake inhibitors are one of the newest antidepressants. These have virtually replaced the older antidepressants as there are fewer side effects. This group includes paroxetine (Aropax), Fluoxetine (Prozac), sertraline (Zoloft) Citaloprom (Cipramil), fluvoxamine (Luvox). This is usually given in low doses and then the dosage gradually increased until the correct dosage is found to avoid any side effects. These drugs do not cause weight gain.
Adverse effects may include drowsiness or insomnia, loss of appetite and weight loss, dizziness or light headedness, tremor, sweating, nervousness, anxiety, dry mouth and nausea.
- These drugs are now used less frequently. The effect of these drugs will not be apparent for 3-4 days and can take much longer (up to 30 days).
- These include imiprimine (Tofranil), amitrypilene (Tryptonol), nortriptyline (Nortab), dothiapin (Prothiaden), doxepin (Sinequin), and tetracyclic mianserin (Tolvon)
- Adverse effects may include impaired reaction time (machinery precaution), sedation, dry mouth, blurred vision, sweating, dizziness, faintness, weight gain and impaired concentration.
- These include Alprazolan (Xanax, Kalma), Diazepam (Valium), Oxazepam (Serepax)
- Treatments duration with this group of medications should be as brief as possible and usually for a few days at the most.
- Adverse effects include drowsiness, sedation, decreased coordination and impaired memory. A reaction involving excitement, aggressiveness and confusion may occur especially in the elderly. These medications may all be addictive.
- These include propanolol (Inderal) This group of medications are most useful for people with prominent cardiovascular symptoms such as a rapid heart rate (tachycardia), palpitations and tremor.
- Adverse effects may include low blood pressure (hypotension) and nightmares.
- Patients with bronchial asthma and with diabetes should not use these medications as they can interfere with other treatments.
- This drug also interacts badly with theophilline and sympathominetics (Sudafed).
- Caution is advised when combining `anti – anxiety’ medication with opiod analgesics (eg codeine).
- Several agents are known to produce ANXIOUS symptoms. They should be avoided or at least restricted. These
- include caffeine, nicotine, some decongestants.
- It is always best to avoid alcohol and marijuana while taking prescribed medications as the effects will be increased. Your judgement will become affected and you risk injury by falling.
- Be aware of the potential side effects that may affect your ability to drive a motor vehicle or handle machinery including power tools.
- Take time to allow your medications to work. It takes time to become unwell and will take time for the medications to take effect.