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
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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.