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Table of Contents (hide)
- 1. Define Your Terms
- 2. Anxiety Spectrum Conditions
- 3. First-Line Pharmacological Treatments
- 4. Second-line Pharmacological Treatments
- 5. Medications Used for Anxiety Spectrum Conditions
When most people think of anxiety conditions they think of conditions such as generalized anxiety disorder (GAD), social anxiety disorder (SAnD) / social phobia, and various panic disorders, especially agoraphobia. Other conditions in the anxiety spectrum include obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). Most of the time anxiety conditions can be treated without medication. When medication is required it is usually for a short duration and/or used as needed (PRN). As with depression, meds should be reserved for when someone isn’t, or is barely able to function due to their condition. Let’s take social anxiety/phobia, as it’s really easy to determine if you need medication for SAnD or not.
- If you can leave you house, hold down a job (even one that involves as little contact with people as possible), and otherwise function, no matter how little interaction you have with anyone else, you can probably overcome the condition with therapy.1 Drugs, if needed, would be used for a very short time.
- If the only time you can leave your house is when you know there will be as few people around as possible, and you’ve adjusted your life so you do your shopping at 3:00 a.m., and only for stuff you can’t get online, then you need meds. Maybe not forever, but probably for more than six-to-eight weeks.
- Benzodiazepines are the traditional pharmacological treatment for most of these conditions. These days they are mostly prescribed for someone who needs to be medicated only occasionally.
- SSRIs, along with some of the more serotonergic antidepressants from other classes, are usually the first meds of choice for anyone with an anxiety spectrum condition who needs to be medicated every day, either in the short term as part of psychological therapy, or in the long term.
- SNRIs - for a lot of people too much norepinephrine is the cause of anxiety, but there are a lot of people who can use a little boost in the adrenergic receptors to help them with their anxiety.
- BuSpar (buspirone), which is in a class all its own2, is the best first choice for GAD when someone is in that nebulous area of too anxious too often for therapy alone with a PRN drug, but not so anxious for an SSRI.
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- Antipsychotics, either by themselves or to augment antidepressants or BuSpar, are also used to treat anxiety disorders.
- Antihistamines. In addition to treating severe allergic reactions, new antihistamines were being developed in the 1950s to deal with two problems prior to surgery: anxiety and anesthesia-induced vomiting3. They’ve been used to treat anxiety ever since. While the more potent ones like Vistaril - which you’ll probably find only in hospitals - are FDA-approved to treat anxiety, OTC antihistamines like Benadryl (diphenhydramine) can work as needed for mild panic/anxiety attacks.
- Beta blockers, like benzodiazepines, are good for when you only need to take a drug PRN. They are mostly used for SAnD, specifically in situations like public speaking or other cases of performance anxiety4.
- BuSpar (buspirone)
- Lexapro (escitalopram)
- Luvox (fluvoxamine)
- Paxil (paroxetine)
- Prozac (fluoxetine)
- Zoloft (sertraline)
- Effexor (venlafaxine)
- Cymbalta (duloxetine)
5.2 Drugs discussed on this site used off-label to treat anxiety spectrum conditions
- Celexa (citalopram) - although it’s approved to treat anxiety conditions in Britain, Ireland, and South Africa. Probably elsewhere as well.
- amoxapine - although approved to treat depression with anxiety
- Invega (paliperidone)
- Risperdal (risperidone)
- Seroquel (quetiapine fumarate)
- Zyprexa (olanzapine)
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- Ativan (lorazepam)
- Klonopin (clonazepam)
- Librium (chlordiazepoxide hydrochloride)
- Tranxene (clorazepate dipotassium)
- Valium (diazepam)
- Xanax (alprazolam)
- Compazine (prochlorperazine)
- Loxitane (loxapine succinate)
- Orap (pimozide): Tourette Syndrome
- Stelazine (trifluoperazine hydrochloride)
- Atarax (hydroxyzine hydrochloride)
- Vistaril (hydroxyzine pamoate)
- Beta blockers:
- acebutolol hydrochloride
- propranolol hydrochloride
- sotalol hydrochloride
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1 Assuming you want to in the first place. I won't go anywhere to deal with stuff like grocery shopping for two, three, sometimes four weeks at a time. Solitude has done wonders for my mental health.
2 In the US at any rate. BuSpar is an azapirone, a class of meds that are mostly anxiolytics and nothing else. A few are also antipsychotics. As of this writing most of them are still in the clinical trial stages everywhere.
3 Not only that, some of the original antipsychotics, like promethazine and Thorazine (chlorpromazine), were originally developed as super antihistamines for pre-operative sedation and to prevent puking. Thorazine was so effective that some people didn't need anesthesia.
4 But not "performance anxiety," or being too nervous or otherwise unable to respond sexually. Which is often a side effect of many crazy meds, especially SSRIs. Although BuSpar is used off-label as an add-on to help with SSRI-induced sexual dysfunction.
|Last modified on Friday, 08 May, 2015 at 11:29:11 by JerodPoore||Page Author: Jerod Poore||Date created: 15 April 2011|
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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
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Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList,
NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
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‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.