First-Line Pharmacological Treatments
- 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 own1, 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.
Second-line Pharmacological Treatments
- 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 vomiting2. 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 anxiety3.
||Keep Crazymeds on the air.
Donate some spare electronic currency
you have floating around The Cloud
1 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.
2 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.
3 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.