MEDICATION MANAGEMENT FOR ANXIETY DISORDERS
Medication treatment of anxiety is generally safe and effective, especially when coupled with therapy. Medication can be either long-term or short-term, depending on the severity of the symptoms and that patient’s goals. However, it can take both time and patience to find the right medication for the patient. During the initial assessment, we will go over previous medications and therapies to find what works best for the patient.
Part of the challenge of medication and why medication management is important is determining the specific dose and timing of medication for each individual. There are no consistent relationships between height, age and clinical response to a medication. Trial often is the best determining factor to finding the most beneficial dosage. Typically, patients will start with a lower dose, increasing dosage in three to seven day intervals until clinical benefits are achieved.
PURPOSE OF MEDICATION IN TREATING ANXIETY DISORDERS
There are four major categories of medications used to treat anxiety disorders.
Selective Serotonin Reuptake Inhibitors (SSRIs) help treat anxiety by clocking the reabsorption (or reuptake) of serotonin by certain nerve cells within the brain. This allows there to be more serotonin available to improve mood. SSRIs typically have fewer side effects than tricyclic antidepressants. However, common side effects can include:
- Insomnia or sleepiness
- Sexual dysfunction
- Weight gain
SSRIs are generally considered an effective treatment for all anxiety disorders, though higher dosages are typically needed in the treatment of obsessive-compulsive disorder.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) can be used for the dual mechanism action. They increase the levels of the neurotransmitters serotonin and norepinephrine by inhibiting their reabsorption into cells in the brain. There are some side effects patients may see:
- Upset stomach
- Sexual dysfunction
- Minor increase in blood pressure
Typically, SNRIs are prescribed to treat generalized anxiety disorder (GAD) and are considered as effective as SSRIs.
The third class, Benzodiazepines, is used for the short-term management of anxiety. They are highly effective at promoting a relaxed feeling and reducing muscular tension that comes with anxiety. Benzodiazepines may be prescribed in conjunction with another class of medication for long-term management as well as covering short-term needs, like panic attacks. When used long-term, benzodiazepines may require a higher dosage to remain effective and can lead to dependence on the drug.
The final class of medications commonly prescribed to treat anxiety is tricyclic antidepressants. This class is typically used when there are concerns about long-term usage on benzodiazepines. Although effective in treating anxiety, there are some significant side effects patients may experience. Side effects can include:
- Drop in blood pressure when standing up
- Urinary retention
- Dry mouth
- Blurry vision