Are you suffering from chronic stress and
anxiety? Have you been trying ways to deal with it naturally but are still struggling?
If so then this is the video for you. We are going to be going over some of the
most common medications that we use to treat anxiety so you can make a more
informed decision with your doctor.
Hi there, I m Dr. Erik Richardson a board
certified Family Practice physician. I d like to welcome you to FamilyMed, a channel
that focuses giving you practical and accurate medical information to help you and your family.
If you think this would be something that is helpful to you make sure you subscribe, hit that
notification button and follow along with us.
Today, we are going to be going over some of
the most common medications that we reach for when we are trying to help somebody
with anxiety. Certainly medication is not the only thing you should rely on when
treating anxiety, but it can be a good tool nothing else you have tried works and
it is starting to control your life. If you are suffering from it, you are not alone.
Anxiety is one of the most common health issues that we see in our clinics. It s estimated
that approximately 20 percent of adults in the United States are dealing with or have
dealt with some sort of an anxiety disorder. The good news though, that I want you leaving
with after watching this video, is that there is hope. There are options that can help and can
keep it from controlling your life. We always like to focus on non-medication techniques to help, so
if you are interested in learning more about that, check out my video on natural ways that
you can help control your anxiety.
I guess before we go into discussing the
different medications, I find that it s helpful to understand a little bit about what
anxiety really is. The best way that I have found to describe it centers around recognizing a
normal reaction in our body that we call the fight or flight response. This is the mechanism that
we have developed, that when confronted with something dangerous, allows our body to ramp up
and either fight it or run from it. For example, if you are walking through a forest and a bear
charges out at you, what s going to happen? Your heart rate elevates, your blood vessels
constrict to allow more blood to the brain, adrenaline is released helping you
to either run or fight for your life. These are normal responses, and they are good
responses, because when the bear is coming after you, you need to react. Anxiety is a condition
where this response is a little too active. It s where these normal responses to scary or
dangerous situations, are overactive or flare up for things that are not dangerous or scary.
So instead of the bear charging in the forest, it s like walking through the trees and a fuzzy
bunny were to hop in front of you. But instead of thinking how cute it is, your body reacts
to it like it was a bear. So that s what is happening with anxiety. Normal day to day life
is triggering that flight or fight response in a way that starts to interfere with your ability to
function. There are some medications that can help you control this response especially when you ve
tried everything else, so let s get into those.
When we look at treating anxiety there
are two general categories of treatment strategies that we try and use. There is an
approach when we try and treat it as you get it and an approach to treat it to try and prevent
it. Within each of these categories there are different types of medications that we can
look at using, depending on your symptoms.
Let s look first at the treat it as you
get it kind of anxiety. This is typically when people have occasional panic attacks or have
situational issues that seem to bring on anxiety. Most commonly these are events like
traveling, flying, being in enclosed spaces, being in crowds or presenting things in front
of people. This would also include your panic attacks that can come out of nowhere and they don
t necessarily have to have a reason. Most of these treatments tend to center around just calming the
anxiety down or creating some sort of sedation to prevent these symptoms from taking you over.
Probably the most common, or at least most talked about, medications used for this type of
anxiety, are in a class of medications called benzodiazepine s. These are your Xanax,
Lorazepam or Valium types of medications. These are a sedating medication, that can be very
effective in treating anxiety that has come on all of a sudden. When you have a significant panic
attack, they can be the most effective treatments. I m not going to go into a full discussion
of thes, but the most important thing to understand about this medication is it isn
t something that you should take very often. The biggest issue with these types of
medications is that they can be very addictive. They aren t designed for or intended to be taken
on a daily basis. Unfortunately, many physicians have been prescribed it this way, and it can be
very difficult to get off of it. I will use them in my practice, but we don t give very many of
them to avoid the potential of addiction. What I tell people, is that if you are having a severe
panic attack and everything else isn t working, then they can be extremely effective. But, if
you find that you need to use them frequently, it s better to find something safer to prevent
the symptoms from coming on in the first place.
Another medication that we will use is
one called Propranolol. I give a better discussion of this medication in this video,
but in short it is a great medication to help for situational type anxiety, especially for
social anxiety and getting up in front of crowds. It helps slow the heart rate down and prevent that
significant anxiety response that can happen when put in those situations. It can be used as a daily
medication for more mild anxiety and it doesn t have the same potential to become addicted.
Another effective medication that can help for more situational anxieties
is a one called hydroxyzine. This is an anti-histamine or in other words a more
powerful version of Benadryl. It can be used as a daily medication but the biggest problem
with it is that it makes you really sleepy, so most people don t do well with it on a regular
basis. It can be quite helpful though for those types of anxiety that affect you most
at night and keep you from sleeping.
So those are the main kinds of medications that
are used when your anxiety doesn t happen every day. But what about when you are always anxious
or you are having frequent panic attacks that you feel like you need to be taking something all
the time. When your anxiety gets to that point it is better to reach for medications that can
help prevent the symptoms from coming on in the first place. As we mentioned before, medications
like propranolol or hydroxyzine can be used on a daily basis but they may not be as effective
for your more significant types of anxiety.
When your anxiety is bad, the most common
medications we will use, belong to the family of medications we refer to as antidepressants.
Working with the different chemicals in the brain like serotonin and norepinephrine we
can help control that debilitating anxiety.
There are two main classes of these medications
that we will use. One we call SSRI or Selective Serotonin Reuptake Inhibitors or SNRI or
Selective Norepinephrine Reuptake Inhibitors. Out of the SSRI s the most effective medications
in controlling anxiety have been Escitalopram, Citalopram, Paroxetine and Sertraline.
Some of the others like fluoxetine and fluvoxamine are felt to be effective as well
but the studies aren t as robust on those.
SNRI s like venlavaxine and duloxetine
have been shown to be effective as well. Both of these classes are meant to be taken
daily to help prevent symptoms from coming on. It usually takes up to 4-6 weeks to see a
full effect, so they aren t meant to be taken on an occasional basis when you have symptoms.
Another medication that is commonly used is called Buspirone. This is in a class of medication all
on it s own, but it does have some similar effects on serotonin. It s used quite a bit to treat
anxiety and is usually tolerated pretty well. It doesn t seem to be as effective as some of the
typical antidepressants, however it has been found to be useful in adding it to some of the SSRI or
SNRI s when more anxiety control is needed.
The last one we are going to talk about
is a medication called gabapentin. This is actually an old anti-seizure medication,
but it has been found to be effective in treating anxiety in some people. It probably isn t the
first medication that most doctors will reach for, but it is typically tolerated pretty well, and
can be helpful when other things may not. I have a video specifically talking about
this one if you want to check it out.
As you can see, there are a lot of
different medications that we can reach for if nothing else is working to treat your anxiety.
We can t go into specifics about each one, in the scope of this video, but hopefully going
over what options are out there can help you, in being a little more informed as you talk to
your doctor about what may be right for you. Talk with them about how often you are really
experiencing bothersome symptoms. If it is occasionally then taking periodic medications
like your benzodiazepines may be appropriate. If it is a fairly regular problem though it
s really best of you stay away from those kind of addictive medications and
focus on ones that can prevent your symptoms from happening in the first place.
Well, I hope you found this to be helpful, if you did, please take the time to give this
video a like and share it with your friends. It helps our channel to grow and reach other people
that may need this in their life. If you haven t done so yet, don t leave without subscribing
and hitting that notification button so you don t miss out on any of our future content.
So until next time, this is FamilyMed with Dr. Richardson and remember to take care of your
body because it s the only one you have.
