Many people worry from time to time. For example, feeling stressed or anxious before a big test is normal and helps us face challenges. But when worries and fear are prolonged and intense, it can disrupt daily life.

Anxiety becomes a disorder when fear and worry make it difficult to concentrate or function and persist for six months or more. People may even experience physical symptoms like heart palpations, sweating, and gastrointestinal issues.

Generalized anxiety disorder, panic disorder, specific phobias, and social anxiety are some of the most common types of anxiety disorders.

Often the difference between anxiety disorders comes down to differences in thinking. People with generalized anxiety disorder (also called GAD) tend to worry about a range of topics. People with social anxiety worry about social interactions (“I’m going to embarrass myself on this date, maybe I should cancel.”). Avoidant behaviour is also a feature of anxiety disorders.

If you think you have an anxiety disorder, speak with your doctor. Any treatment for anxiety should be checked by a doctor or licenced professional.

What treatments are prescribed for anxiety?

Research has shown that the most effective treatment for anxiety is Cognitive Behavioural Therapy (CBT). CBT is a type of talk therapy that helps you change negative thought patterns and avoidant behaviours, while also teaching coping skills. Talk therapy has been found more effective than medications in treating anxiety disorders. Yet some people with severe debilitating anxiety may need medication to be able to do CBT. Medications alone won’t cure an anxiety disorder but can help manage it.

Medications for anxiety:

Not all anxiety medications are the same. Several different types of drugs can be used to treat anxiety:

• Antidepressants
• Benzodiazepines
• Buspirone
• Hydroxyzine
• Beta-blockers

Different types of drugs work differently to control anxiety symptoms. Beta-blockers for example, make your heart beat more slowly and with less force, which decreases blood pressure. People who suffer panic attacks can benefit from beta-blockers for this reason. Benzodiazepines, such as Xanax, Ativan, and Valium, work quickly in the brain and nervous system to produce feelings of relaxation. Unfortunately, benzodiazepines can cause dependency and are not intended for long-term use. For long-term treatment, antidepressants are usually prescribed.

Antidepressants to treat anxiety

Antidepressants are usually the first medication prescribed for anxiety disorders. One of the reasons why is because antidepressants do not cause dependency, like with benzodiazepines.
Antidepressants fall into different classes depending on the mood-related brain chemicals they target. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed class of antidepressant. SSRIs work to boost serotonin levels in the brain.

Randomised controlled trials (RCTs) show evidence of antidepressants being effective for anxiety. SSRIs in particular are found most effective at treating generalized anxiety disorder. Antidepressants also treat other types of anxiety.

When SSRIs don’t work, or side effects become too much to tolerate, a doctor may prescribe another class of antidepressant. Usually a serotonin and noradrenaline reuptake inhibitor (SNRIs) is prescribed.

Depending on your metabolism, some antidepressants may work better than others. Some people find the side effects of antidepressants hard to live with. These include: nausea, increased appetite and weight gain, sexual problems, fatigue and drowsiness, insomnia, dry mouth and blurred vision.
As always, speak to your doctor before deciding to stop or switch medications. Antidepressants should never be stopped abruptly.

Benzodiazepines for anxiety

Benzodiazepines can help relieve anxiety by quickly producing a sedative effect, unlike antidepressants that take anywhere from 4-6 weeks to kick in. Benzodiazepines, also known as tranquillizers, are used for generalized anxiety disorder, panic disorder, and social anxiety disorder. People taking these drugs can build up a tolerance, needing more of the medication to feel better. Benzodiazepines are considered addictive and are not intended for long-term use – usually no longer than a month. Unfortunately, many people use benzodiazepines for years at a time. Stopping medications suddenly can be dangerous. It is important to speak to a doctor before stopping benzodiazepines as usage needs gradual lowering.

Common side effects of benzodiazepines include: drowsiness, dizziness, nausea, blurred vision, headache, confusion, tiredness/fatigue, and nightmares. Depending on how well you metabolize benzodiazepines, side effects can be more severe. Benzodiazepines are particularly risky for seniors as they increase risk of falls. Still, benzodiazepines can be an effective tool to manage anxiety when used properly.

Other medications for anxiety

Buspirone (brand name BuSpar) is typically used to treat generalized anxiety disorder. It is often prescribed with an antidepressant. Buspirone has been found effective at relieving anxiety symptoms such as jitteriness and irritability. It is not considered addictive, but some experts argue it can be habit forming due to its sedative effect. Researchers are not exactly sure how buspirone works in the brain, but it can be helpful for people who suffer from both anxiety and depression at the same time.
Beta-blockers, often used as heart medications, have been found to be helpful for panic disorders and people who suffer from social anxiety. They are meant to be taken on an “as needed” basis, like before a big performance. Beta-blockers work to alleviate physical symptoms such as heart racing, sweating, and shakiness.
Hydroxyzine (Atarax, Vistaril) is an allergy medication that has also been prescribed for anxiety. It works quickly and is not considered addictive like benzodiazepines.

Can Pillcheck help me find the right anxiety medication?

Some people respond better to certain medications than others. Depending on our inherited metabolism, antidepressants and other classes of drugs affect people differently. Some people metabolize more slowly or too fast, increasing unpleasant side effects and making treatment less effective.
Pillcheck tests your inherited drug metabolism and can determine if you should avoid benzodiazepines, or which antidepressants work best for you.
To find out more, please visit www.pillcheck.ca