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A Guide to Antianxiety Meds

A Guide to Antianxiety Meds

Medication can help you conquer anxiety—but which one is best for you?

You’ve tried everything you can think of to beat your anxiety—from therapy to yoga to jogs in the park. But nothing seems to help.

“The research is clear,” says Colleen Cira, Psy.D., a licensed clinical psychologist and director of the Cira Center for Behavioral Health. “A combination of therapy and medication can be the most effective way to treat anxiety. But if you’re stuck, it may be time to reach out to your doctor.”

Be cautious though. Medication shouldn’t be your first approach. The most effective treatment for anxiety disorders is cognitive behavioral therapy (CBT). In fact, lots of anxiety problems can be addressed without meds.

However, if you opt for medications, how do you know which one is right for you? There are dozens of antianxiety meds. Here are some things to know to help you—and your doctor—make the best choice.

Learn how to find the right treatment to make you feel better

But first, ask about being tested with the Genomind Genecept Assay, a genetic test that can help your clinician understand if a particular drug is more or less likely to work for you—or, conversely, more likely to be poorly tolerated.

This can help get you on the right medication sooner and help you avoid the trial and error that often comes with figuring out the best drugs for anxiety.

Benzodiazepines

There are fast-acting meds that can calm you down when you’re having a panic attack or help you board a plane when you’re terrified to fly. Some examples:

  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)
  • Diazepam (Valium)
  • Lorazepam (Ativan)

These drugs, called benzodiazepines, work by supercharging GABA—the neurotransmitter, or chemical messenger, that reduces activation in neurons all over the body. That boost of GABA slows down the amygdala (the part of your brain that detects danger and gets you pumped up to face emergencies), as well as the responses it creates, like a pounding heartbeat, sweating, or the impulse to run or fight.

Benzos, as they’re known, have a tranquilizing effect on your amygdala. They can help slow the amygdala down, but they also keep it from learning new ways to respond, so they don’t correct the situation.

Your doctor might prescribe benzos as the quickest treatment, but they are not best for long-term use. Running around the block and deep slow breathing may work faster at calming the amygdala.

But be very careful: Benzos can’t be used on a daily basis without a lot of risk. If you take them regularly, they’re likely to become habit-forming, and they’re among the toughest drugs to quit.

Find out how your body metabolizes medications

SSRIs and SNRIs

You’ve probably heard of drugs like Zoloft and Cymbalta. They’re usually known as antidepressants, but it turns out they can help with anxiety too. They work by targeting serotonin or norepinephrine—two of the neurotransmitters that carry signals from one brain cell, or neuron, to the next.

They take a few weeks to kick in, but when they do, they prevent those chemicals from being reabsorbed into the neuron. That keeps them in the synapse, the tiny space between your neurons, for a longer time. And when that is maintained for about a week or so, your neurons begin to change. These drugs make your neurons more flexible. Your brain begins to restructure itself, making it easier for you to learn new things.

SSRIs (selective serotonin reuptake inhibitors) target the neurotransmitter serotonin, while SNRIs (or serotonin and norepinephrine reuptake inhibitors) target both serotonin and norepinephrine.

Scientists think that SSRIs and SNRIs help rewire the circuits of your brain responsible for fear and anxiety. When those meds are combined with therapy, studies show that the results are often better—and quicker—than therapy alone.

Some examples of these medications:

SSRIs

  • Sertraline (Zoloft)
  • Citalopram (Celexa)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)

SNRIs

  • Venlafaxine (Effexor XR)
  • Desvenlafaxine (Pristiq)
  • Duloxetine (Cymbalta)

These drugs aren’t addictive, but they may have some uncomfortable side effects, like dry mouth, drowsiness, and headaches. One thing to look out for: Some people experience discontinuation symptoms when quitting abruptly. If you decide to stop, make sure you cut back slowly, with your doctor’s guidance.

Beta Blockers

Beta blockers are designed to treat heart disease and high blood pressure—but sometimes doctors prescribe them “off-label” to treat anxiety.

They work by blocking the effects of norepinephrine—a neurotransmitter that triggers the fight-or-flight response. If you’re having an anxiety attack, you’ve got lots of norepinephrine pumping through your body, making your heart beat faster, your palms sweat, and your head feel a little dizzy. Beta blockers can help you take all of that down a notch.

They don’t “cure” anxiety, but they can help lessen the physical symptoms, especially when you’re unusually nervous, like before a big presentation.

Some of the beta blockers used to treat anxiety off-label:

  • Propranolol (Inderal)
  • Atenolol (Tenormin)

Beta blockers aren’t addictive, but they may have some side effects, like dizziness, breathing problems, and nausea. And you should not stop taking them suddenly, as that could be dangerous.

 

Disclaimer: Genomind does not endorse certain medications for the treatment of anxiety. All medication should be taken under a clinician’s care. Do not discontinue use without your doctor’s permission.

Categories: Personalized Medicine

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19 Comments

  1. Barbara 4 weeks ago

    What about Tofranil?

    • Genomind 3 weeks ago

      Thank you for your message, Barbara. This blog focuses on the top prescribed medication for anti-anxiety and does not cover every medication as indicated for the treatment of depression. If you have any questions regarding certain medication and its usages, we recommend talking to your doctor directly. If you have any questions regarding the medication on the Genomind Professional PGx report please feel free to reach out to customer service at 877-895-8658.

  2. Catherine 4 weeks ago

    I have been on Citalopram for many years and quite frankly it is causing the same symptoms that I was taking it for now. I have insomnia, heightened anxiety and things that this medicine was supposed to clear up but actually is one of the side effects. I tried to stop taking it and the withdrawal was just unbelievable and horrible, so now I’m back on it. Any suggestions to get off of citalopram?

    • Genomind 4 weeks ago

      Hi,Catherine, We’re sorry to hear about your experience with Citalopram. We invite you to look at our Get Started page to get a downloadable guide for talking to your doctor about informing your treatment options with DNA testing and help finding a provider https://start.genomind.com/.

  3. Sandy Pierce 4 weeks ago

    How long can you take Paxil and Inderal? I’ve been on both for 18 years, the physician who prescribed for me retired and my new Primary physician wants to D/C the Inderal. Frankly I’m hesitant to change anything, my anxiety is so much better and I don’t want the panic attacks to return

    • Genomind 4 weeks ago

      Hi, Sandy, We invite you to look at our Get Started page to get a downloadable guide for talking to your doctor about informing your treatment options with DNA testing and help finding a provider https://start.genomind.com/.

  4. Michelle Engard 4 weeks ago

    My anxiety/depression seems to be getting worse. I have tried three medications. All seems to work well in the beginning. But then the side effects kick in. My main one is always nauseous. Hate it! Can’t stand it! With me refusing anymore medication. I now feel stuck and doomed!! HELP!!!

    • Genomind 4 weeks ago

      Hi, Michelle, we are so sorry to hear about your struggle with anxiety/depression. Genomind Professional PGx DNA testing can help your clinician make a more informed decision about your treatment options. We invite you to look at our get started page for a downloadable guide for talking to your doctor or find a doctor in your area that offers the test by finding a provider at https://start.genomind.com/

  5. Stephen 1 month ago

    You have completely ignored the genetic component of anxiety. I have experienced every treatment, from meds to behavioral, to naturalistic. The only thing that has allowed me to live a life I was born to was clonazepam. Both parents were extremely anxious and I have no idea how far back it goes familialy. I only know I would never have been able to achieve my doctorate without clonazapam…life is not fair.

    • Genomind 1 month ago

      Stephen, the subject of this article is specifically focused on the factors that should be considered when looking for effective anxiety meds – including how genetics plays a role in an individual’s experience with certain drugs.  But certainly, our genes determine our traits and genetic variations make us all unique. These differences may also impact our health.  Please check out the Mindful DNA section of our website.  This DNA testing looks at genes to determine which can impact current or future health conditions. https://genomind.com/mindful-dna-professional/for-patients/

  6. Carole Jaklitsch 1 month ago

    Thank you for this article. I found it to be useful
    Please keep me informed on anything else that may be useful. I’m 74 and can’t find a doctor to prescribe me anything for my crippling anxiety since the government has put the brakes on the meds. I do not want to live the rest of my life feeling like this. Some of the reasons are “They are habit forming “ I may get dizzy and fall “ They may cause me to have confusion “ I need help!!!

  7. Diane McMahan 2 months ago

    I have been on EffexorXR for years. If I miss just one pill I am so nauseated throwing up and dizzy even within the following day. What would cause that? I feel like I am addicted to it??

    • Genomind 2 months ago

      We are sorry to hear about your experience with Effexor.  Any side affects you personally experience should be discussed with your clinician who can provide you guidance.  If you have any questions regarding Genomind Professional PGx please feel free to reach out to Customer Service at 877.895.8658

      • Ric 1 month ago

        I had anxiety most of my life. Insomnia as well. Panic attacks began in late 20s. Dr prescribed Xanax. It worked wonderfully. Later Dr put me on Prozac. It started well but I became manic and impulsive. Other SSRIs made me crazy and I did things I srill regret. The last SSRI I tried was Klonopin. I fell apart emotionally. Now.I have been on Buproprion and Xanax for over a decade and finally all is well. I just can’t go back and fix those things that happened when I was on SSRIs and most people don’t understand. Now Drs are being pressured to reduce Xanax because some people abuse them. I’m hoping to keep present meds as I finally feel normal and relatvely happy.

      • Genomind 1 month ago

        Hi, Ric! Thanks for sharing a little about your own journey to finding the right treatment.

      • Nancy Evanson 1 month ago

        Having trouble findings someone to do the tests Willingto self pay. Will go to Camden county If necessary Judy need help

      • Genomind 1 month ago

        Hi Nancy, we are so sorry to hear about your struggle to find a doctor. We invite you to look at our get started page for a downloadable guide for talking to your doctor and help finding a provider https://start.genomind.com/ or please have your clinician give us a call at (877) 895-8658 for information about self pay.

  8. Dina tonn 3 months ago

    I live in leesburg,ga, I can’t get any of my doctors to order this test.the nearest doc that does this test is too far away,in Atlanta..any suggestions.

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