What Can I Take for Anxiety While Breastfeeding

What Medications are Prescribed to Help With Anxiety?

Medically Reviewed by Madeline Hubbard, RN, BSN.

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The National Alliance on Mental Illness (NAMI) estimates that anxiety affects roughly 19% of the adult population in the United States, making it the most commonly experienced psychiatric disorder.

Some typical anxiety symptoms include excessive worry or dread; i rritability; i nsomnia or altered sleep patterns; t ension or restlessness; and e levated heart rate or shortness of breath. Symptoms of anxiety and depression often occur together, which can cause many who suffer from both to experience "roller-coaster-like" moods that disrupt their daily life. Although anxiety can be debilitating, only about 37% of those with anxiety disorders are engaged in treatment.

There are several different treatment options available for anxiety. In fact, medication isn't always the first suggestion. Often, a physician or psychiatrist may recommend therapy, such as cognitive behavioral therapy (CBT), which can be done with or without medication.

Psychotropic Medications

Medications that are prescribed for mental health disorders are called psychotropic medications. These medications work to alter the level of different neurotransmitters in the brain, which can have an impact on one's mood. It is very important to work closely with a healthcare and/or psychiatric professional when trialing psychotropic medications, as they must be prescribed in sage dosage amounts and consistently monitored. Oftentimes, individuals try multiple different medications before finding one that is tolerable and effective for them.

Antidepressants

Typically, the first type of psychotropic medication prescribed for anxiety is actually an antidepressant drug. These antidepressants, which are from a classes of medication called selective serotonin reuptake inhibitors (SSRIs) or, less commonly, serotonin-norepinephrine reuptake inhibitors (SNRIs), include:

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

Medications from these classes work by changing the level of either serotonin or norepinephrine in parts of the brain, thus impacting one's mood over time. SSRIs and SNRIs typically take four to five weeks to have an effect on one's symptoms. Additionally, folks who are prescribed these medications should be aware of the common side effects, which include:

• Headache
• Dizziness
• Fatigue
• Insomnia
• Nausea or diarrhea
• Weight gain
• Decreased sexual response
• Increased thoughts of suicide

If SSRIs or SNRIs are effective at alleviating anxiety symptoms, they may be prescribed daily and/or on an ongoing basis. These medications can help to address symptoms of generalized anxiety, social anxiety, and/or phobia disorders.

Benzodiazepines

The benzodiazepine class of drugs can be very effective at treating anxiety symptoms. However, these are typically prescribed to treat acute episodes of anxiety since they are a controlled, and oftentimes addictive, substance. As one's tolerance develops, the patient may need an increased dose to experience the same effect, which can lead to a dependence — and, when stopped, a withdrawal. For this reason, this class of drug is not often prescribed for the long term.

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Nonetheless, benzodiazepines may help in the short term or on an as-needed basis. Most commonly, this class of drug is prescribed to folks managing severe anxiety, anxiety-related sleep problems, and panic disorders. Examples of benzodiazepines include:

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

If one is prescribed a benzodiazepine, great care should be taken. For example, one should never take a benzodiazepine drug with alcohol. Additionally, the following side effects should be monitored closely:

• Nausea
• Drowsiness or fatigue
• Dizziness or muscle weakness
• Decreased blood pressure
• Difficulty concentrating
• Slurred speech
• Worsened depression

Other Medications to Treat Anxiety

There are many other medications that are sometimes prescribed to treat anxiety disorders. Shown to be effective over time, these medications can be good options to explore for individuals who do not tolerate, or feel an effect from, SSRIs, or cannot safely be prescribed benzodiazepines.

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• Beta Blockers (Propranolol, Atenolol) can help to manage short-term physical symptoms of anxiety by bringing down heart rate or blood pressure.
• Buspar (Buspirone) is an anxiolytic medication that can be prescribed for anxiety particularly when a patient is sensitive to SSRI treatment. Many patients report positive results after several weeks of treatment.
• Atarax or Vistaril (Hydroxyzine) is part of the antihistamine class like the over-the-counter drug Benadryl, but has a different mechanism of action that makes it effective for reducing anxiety symptoms.

If feelings of dread or fear are interfering with your daily life, reaching out to a mental health professional is a solid first step when it comes to finding an effective anxiety treatment or approach. Remember that with any new medication regimen, it is vital to monitor said medication's effects closely and be in constant communication with your healthcare provider.

Resource Links:

• Facts & Statistics (Anxiety and Depression) via Anxiety and Depression Association of America
• "Anxiety Disorders" via National Institute of Mental Health
• "Mental Health Medications" via National Institute of Mental Health
• "Anxiety Disorders" via Mayo Clinic
• "Mental Health Medications" via National Alliance on Mental Illness (NAMI)
• "Selective serotonin reuptake inhibitors (SSRIs)" via Mayo Clinic
• "Benzodiazepine-Associated Risks" via National Alliance on Mental Illness (NAMI)

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