Anti-Anxiety Medications

What are anti-anxiety medications?

Anti-anxiety medications help reduce the symptoms of anxiety, such as panic attacks, or extreme fear and worry. The most common anti-anxiety medications are called benzodiazepines. Benzodiazepines can treat generalized anxiety disorder. In the case of panic disorder or social phobia (social anxiety disorder), benzodiazepines are usually second-line treatments, behind SSRIs or other antidepressants. Benzodiazepines are a type of sedative and are usually a short-term treatment. You should not take benzodiazepines for longer than a month as they are highly addictive.

Benzodiazepines used to treat anxiety disorders include:

Short half-life (or short-acting) benzodiazepines (such as Lorazepam) and beta-blockers are used to treat the short-term symptoms of anxiety. Beta-blockers help manage physical symptoms of anxiety, such as trembling, rapid heartbeat, and sweating that people with phobias (an overwhelming and unreasonable fear of an object or situation, such as public speaking) experience in difficult situations. Taking these medications for a short period of time can help the person keep physical symptoms under control and can be used “as needed” to reduce acute anxiety.

Buspirone (which is unrelated to the benzodiazepines) is sometimes used for the long-term treatment of chronic anxiety. In contrast to the benzodiazepines, buspirone must be taken every day for a few weeks to reach its full effect. It is not useful on an “as-needed” basis.

How do people respond to anti-anxiety medications?

Anti-anxiety medications such as benzodiazepines are effective in relieving anxiety and take effect more quickly than the antidepressant medications (or buspirone) often prescribed for anxiety. However, people can build up a tolerance to benzodiazepines if they are taken over a long period of time and may need higher and higher doses to get the same effect. Some people may even become dependent on them. To avoid these problems, doctors usually prescribe benzodiazepines for short periods (4-6 weeks), a practice that is especially helpful for older adults (read the NIMH article: Despite Risks, Benzodiazepine Use Highest in Older People), people who have substance abuse problems and people who become dependent on medication easily. If people suddenly stop taking benzodiazepines, they may have withdrawal symptoms or their anxiety may return. Therefore, benzodiazepines should be tapered off slowly.

What are the possible side effects of anti-anxiety medications?

Like other medications, anti-anxiety medications may cause side effects. Some of these side effects and risks are serious. The most common side effects for benzodiazepines are drowsiness and dizziness. Other possible side effects include:

  • Nausea
  • Blurred vision
  • Headache
  • Confusion
  • Tiredness
  • Nightmares

Tell your doctor if any of these symptoms are severe or do not go away:

  • Drowsiness
  • Dizziness
  • Unsteadiness
  • Problems with coordination
  • Difficulty thinking or remembering
  • Increased saliva
  • Muscle or joint pain
  • Frequent urination
  • Blurred vision
  • Changes in sex drive or ability (The American Society of Health-System Pharmacists, Inc, 2010)

If you experience any of the symptoms below, call your doctor immediately:

  • Rash
  • Hives
  • Swelling of the eyes, face, lips, tongue, or throat
  • Difficulty breathing or swallowing
  • Hoarseness
  • Seizures
  • Yellowing of the skin or eyes
  • Depression
  • Difficulty speaking
  • Thoughts of suicide or harming yourself

Common side effects of beta-blockers include:

  • Fatigue
  • Cold hands
  • Dizziness or light-headedness
  • Weakness

Beta-blockers generally are not recommended for people with asthma or diabetes because they may worsen symptoms related to both.

Possible side effects from buspirone include:

  • Dizziness
  • Headaches
  • Nausea
  • Nervousness
  • Lightheadedness
  • Excitement
  • Trouble sleeping

Anti-anxiety medications may cause other side effects that are not included in the lists above. For more information about the risks and side effects for each medication, please see Drugs@FDA.

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