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Psychiatry & Medication

Prescription Medications for Anxiety

 May 11, 2020

By  Natalie Kirilova

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The Bottom Line

  • Anxiety is an emotional condition with varying severity.
  • There are 5 major types of anxiety, they are Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), Panic Disorder, Social Anxiety Disorder (SAD), Post-Traumatic Stress Disorder (PTSD).
  • Anxiety treatment includes FDA-approved prescription medications that have been approved specifically for anxiety and off-label medications that can sometimes be prescribed for anxiety by a doctor.

What is Anxiety?

Anxiety is an emotional and physical manifestation, usually caused by stress, fear, or worry. It is often manageable and a normal human emotion that is linked to a body’s natural response to a potential threat. However, anxiety levels may surpass moderate levels and may become uncontrollable, accompanied by panic attacks, depression, or interfere with your life. At this point, it is your nervous system and body’s alert to speak to your doctor about taking prescription medications for anxiety or undergoing certain therapies for anxiety. If not treated, anxiety may lead to a medical disorder.

Today, anxiety is the most diagnosed mental illness in the USA. Over 40 million people suffer from it yearly.  Anxiety is considered to be highly treatable. However, less than 40% of those suffering from anxiety actually seek treatment. It also usually takes a very long time to be diagnosed. It takes on average 9-12 years for a female to be diagnosed with anxiety after the start of symptoms. 

If you decide that treatment with prescription medication for anxiety may be for you, you must speak with a doctor (usually General Practitioner or a Psychiatrist) and only your doctor may prescribe you medication. You can find out how to find a psychiatrist near you here. 

To understand your level of anxiety, you can take this self-assessment test. 

Different Types of Anxiety

Medical experts determine five major types of anxiety disorders and use certain prescription medications for anxiety to treat them. 

Generalized Anxiety Disorder (GAD). Patients diagnosed with GAD experience preoccupation, anticipation of danger or catastrophe, or they are bothered with the daily life that before seemed normal. GAD can develop gradually and manifest itself in irritability, excessive nervousness, sweating, and difficulty sleeping. Cognitive-behavioral treatment (CBT) alongside prescription medications from selective serotonin reuptake inhibitors (SSRIs) group have shown efficacy for GAD. However, there’s a large variety of treatment plans, those that include and do not include prescription medication for anxiety.

Obsessive-Compulsive Disorder (OCD). Together with other types of anxiety disorders, OCD may interfere with your daily routine. It is manifested in repetitive behaviors or obsessions over certain things-to-do such as hand washing or overthinking. Also, this mental disorder is sometimes linked to a fear of being contaminated by touching other people or an inability to throw away unnecessary items. A doctor may occasionally prescribe medications for anxiety or antidepressants. Again, other modalities are available to treat OCD. 

Panic Disorder. The panic may occur unexpectedly and be followed by accompanying symptoms of sweating, trembling, accelerated heart rate, trouble breathing. Patients diagnosed with this disorder are often anticipating the next panic attack and building a plan to avoid it. Doctors may prescribe SSRIs medications to treat this health condition. Again, other modalities are available to treat OCD. 

Post-Traumatic Stress Disorder (PTSD). Compared to other types of anxiety disorders, PTSD is linked to stressful events that harmed or threatened the patient’s life. Events can be connected to military service, violence, bullying, natural disasters among others. SSRIs medications are usually prescribed to treat PTSD alongside psychotherapy. Lately, a lot of promising research has supported the use of mind-altering medicines for PTSD, such as MDMA, psilocybin, and ketamine. Other modalities are also available. 

Social Anxiety Disorder (SAD). Doctors may diagnose SAD in people who have excessive worries or fear of socialization. They may be scared to talk to other people, eat or drink next to them, or work in a team. They prefer avoiding crowds and staying alone. CBT alongside depression medications may be prescribed for use in patients with SAD. Other modalities are also available to treat SAD.

This article will focus on the coverage of prescription medications for anxiety. However, there is a variety of other modalities and treatment plans that are available for all types of anxiety. 

What are the different types of medications for anxiety?

All types of anxiety require prompt attention and treatment from a doctor. Specific treatment can alleviate symptoms, help balance a healthy clear of mind and minimize stress triggers. Speak to your doctor about a prescription medication for anxiety that may be fit for your health condition. 

This is not a comprehensive list of all prescription medications for anxiety, get to know more about other prescription medications from your doctor.

Prescription medications for anxiety approved by the FDA require a legal prescription to be dispensed. They are safe and effective for anxiety according to the FDA only when prescribed and used under your doctor’s supervision. Off-label medications for anxiety have not been approved by the FDA for this health condition, however, a doctor may occasionally prescribe them if the benefits prevail risks, or no other medication showed efficacy.

Prescription medications 

Selective serotonin reuptake inhibitors for anxiety

  • Celexa;
  • Cipralex;
  • Lexapro;
  • Luvox;
  • Paxil;
  • Prozac;
  • Zoloft.

Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that increase serotonin levels. The prescription medication from SSRIs class slows down the absorption of serotonin in the blood to keep the high levels of serotonin for regulating mood and relieving the anxiety symptoms. They take 3 to 6 weeks on average to start showing effects, however, it may not always be fit for your medical condition. Speak to your doctor about the safe use of SSRIs.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

  • Cymbalta;
  • Effexor;
  • Pristiq.

Unlike SSRIs, SNRIs medication works simultaneously on two neurotransmitters. This prescription medication is believed to minimize the reuptake of serotonin and norepinephrine chemicals in the brain and then, improve a person’s mood, reduce anxiety and depression. SNRIs effect can usually be observed in a couple of weeks.

Tricyclic antidepressants 

  • Elavil;
  • Pamelor;
  • Norpramin;
  • Tofranil.

Tricyclic Antidepressants (TCAs) are medications to treat anxiety symptoms and most often for panic disorder. The prescription medication from TCAs class works similarly to SNRIs by affecting serotonin and norepinephrine levels.

Benzodiazepines

  • Valium;
  • Xanax;
  • Klonopin;
  • Librium;
  • Ativan;

Benzodiazepine (Benzo) medication is prescribed for short-term treatment of generalized anxiety disorder (GAD). It works as a tranquilizer which helps relax and slow down the activity of the nervous system. However, Benzodiazepines may have anxiety as a side effect. It may not be fit for your health condition. Speak to your doctor about taking Benzo medications.

Off-label medications prescribed for anxiety 

A doctor may prescribe other medications for anxiety which are not approved by the Food and Drug Administration (FDA) but occasionally used off-label for anxiety treatment. It happens when first-line prescription medications do not show efficacy or cause many side effects. Note, this is not an extensive list of off-label medications. Speak to your doctor to know what fits you best.

  • Lyrica;
  • Buspar;
  • Antivert;
  • Neurontin;
  • Gabitril;
  • Topamax;
  • Trazodone;
  • Seroquel XR;
  • Hydroxyzine;
  • MAOIs;
  • Beta-Blockers.

Lyrica (Pregabalin)

Pregabalin is an off-label prescription medication for anxiety. It is FDA-approved for neuropathic pain. Structurally, Pregabalin is similar to gamma-aminobutyric acid (GABA) which has shown to have an antianxiety effect. A doctor may prescribe it for generalized anxiety disorder (GAD).

Buspar (Buspirone)

Buspirone is a serotonin receptor antagonist. This prescription medication is used off-label for anxiety. Today, FDA discontinued Buspar but generic Buspirone is still available for prescription. It works by affecting neurotransmitters in the brain which then develop an anti-anxiety effect. 

Antivert (Meclizine)

Meclizine is a prescription medication from the class of antihistamines that are usually used to treat allergies. It is not FDA approved for anxiety but may be prescribed off-label for anxiety. It is believed to suppress panic attacks, emotional stress or anticipation of dangerous outcomes typical for generalized anxiety disorder (GAD).

Neurontin (Gabapentin)

Gabapentin is an anticonvulsant medication FDA-approved for seizure treatment. It may be prescribed off-label for anxiety. It imitates GABA activity and affects brain chemicals responsible for the nervous system functions. 

Gabitril (Tiagabine)

Tiagabine is an antiepileptic medication. An off-label indication is linked to generalized anxiety disorder (GAD) treatment. This prescription medication for anxiety is believed to increase GABA activity. It is often used in combination with other medications.

Topamax (Topiramate)

A doctor may prescribe Topamax for anxiety, PTSD, and mood disorders. The FDA suggests this medication only to treat convulsions. Besides, the FDA considers its intake with a black box warning, as it may increase suicidal thoughts.

Trazodone

Trazodone’s mechanism for anxiety relief is not clearly outlined. It is a triazolopyridine derivative from the group of serotonin receptor antagonists SARIs and it is believed to increase serotonin levels.

Seroquel XR (Quetiapine XR)

Quetiapine is most likely to be prescribed off-label for generalized anxiety disorder (GAD). The mechanism of action is not clearly understood but it is believed to balance certain chemicals in the brain.

Hydroxyzine (Atarax, Vistaril)

Hydroxyzine is an antihistamine prescription medication and can sometimes be prescribed off label for anxiety. It works by reducing the central nervous system function and lowering anxiety symptoms. A doctor may administer it before or after the surgery to help relax a patient. It fits best the short-term treatment.

MAOIs

  • isocarboxazid (Marplan);
  • phenelzine (Nardil);
  • selegiline (Emsam);
  • tranylcypromine (Parnate).

Monoamine oxidase inhibitors (MAOIs) are depression medications sometimes prescribed off-label to treat generalized anxiety disorder (GAD), panic attacks, and obsessive-compulsive disorder (OCD). 

Beta-Blockers

Beta-Blockers are medications such as Tenormin and Inderal that affect norepinephrine and minimize symptoms of anxiety. However, doctors prescribe them primarily to treat high blood pressure.

Disclaimer: This website does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on our Site. If you think you may have a medical emergency, immediately call your doctor or dial 911


Natalie is a writer with a focus in medical research with over 10 years of experience

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