Everything You Need To Know About Anxiety Medication

I have gathered the most insightful information on anxiety medication and put them all in one blog post. The information came from various popular medical websites, such as Centre for Addiction and Mental Health, Help Guide, Anxieties.com, and WebMD. My hope is that you find this easy to read and understand.

The two most used anti-anxiety medications are benzodiazepines and antidepressants. Since I just did a whole blog post on antidepressants, this post will focus more on benzodiazepines. To read my blog post on antidepressants, click on the link below.

Everything You Need To Know About Antidepressants

What is Anxiety Medication?

“Many different types of medications are used in the treatment of anxiety disorders, including traditional anti-anxiety drugs such as benzodiazepines (typically prescribed for short-term use) and newer options like SSRI antidepressants (often recommended as a long-term anxiety solution).”[1]

Most widely prescribed type are Benzodiazepines (Xanax, Klonopin, Valium, Ativan). They are very effective when taken during a panic or anxiety attack, or a different overwhelming episode because they work quickly. They typically bring relief within 30 to 60 minutes after taking it.[2]

Benzodiazepines are helpful can be used in the following ways:

  • On occasion – to help you sleep or when anxiety can’t be controlled
  • Daily, for up to a few weeks, while waiting for an antidepressant or other treatment to take effect.
  • “Some people may continue to use benzodiazepines for longer, even months or years. Some do so because they continue to find these drugs helpful and have agreed with their prescribing physician that the benefits of continuing to use them outweigh the risks.” [3]

What Conditions Are Benzodiazepines For?

  • Anxiety
  • Insomnia
  • Alcohol withdrawal
  • Seizure control
  • Muscle relaxation
  • Inducing amnesia for uncomfortable procedures[4]

Do Benzodiazepines work?

“Studies suggest that they are effective in reducing symptoms of anxiety in approximately 70-80% of patients.”[5]

Like antidepressants, benzodiazepines work best when they are combined with talk therapy, support from loved ones, and self-care.

How do Benzodiazepines Work?

“Benzodiazepines are minor tranquilizers (sedatives) that prevent or reduce anxiety, sleeplessness, muscle spasms, seizures, and other problems by slowing down the central nervous system.”[6]

Side Effects of Benzodiazepines

Side effects include:

  • Drowsiness
  • Dizziness
  • Poor balance or coordination
  • Slurred speech
  • Trouble concentrating
  • Memory problems
  • Confusion
  • Stomach upset
  • Headache
  • Blurred vision[7]

Be willing to tolerate some minor side effects. Side effects may also fade after you take them for a couple weeks. Usually the benefits outweigh any minor side effects.[8]

“If side effects still bother you [after a couple weeks] and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.”[9]

Benzodiazepines and Risk of suicide

Benzodiazepines are not known to increase the risk of suicidal thoughts or attempts.

However, as a reminder from my last blog post, antidepressants may increase the risk in people under 25, so it is important to monitor moods and behaviours if you decide to take those.

Benzodiazepines and Pregnancy

The risk of birth defects from taking benzodiazepines while pregnant is thought to be very small. “If benzodiazepines are used regularly close to the delivery date, the baby may be born drowsy or may have withdrawal symptoms such as restlessness and feeding problems.” Small quantities of benzodiazepines can be passed through breast milk, which may cause drowsiness in the baby.[10]

Are Benzodiazepines Addictive?

“It is very easy to become dependent on benzodiapines in as little as four weeks.”[11]

“When used on occasion or daily for a few weeks, benzodiazepines have a low risk of addiction. This risk increases, however, when benzodiazepines are taken regularly for more than a few weeks, especially when they are taken in higher than normal doses. People with a history of substance abuse should avoid or minimize use of benzodiazepines as they are at higher risk of becoming addicted.”[12]

Signs of addiction include:

  • Strong cravings for the effects of the drug
  • Taking more of the drug than intended
  • Continuing to use the drug despite the problems it may cause

An alternative to avoid addiction are antidepressants as they have a much lower risk of it. However, as explained in my last blog post, it can still cause withdrawal effects.

How do I Safely Use Benzodiazepines?

“Take only as directed by your doctor; do not increase your dose.”

“Once you have slept well for two or three nights in a row, try to get to sleep without taking the medication.”

“If you have been taking benzodiazepines regularly for a few weeks or more, check with your doctor before reducing or stopping your medication.”[13]

Drinking Alcohol While on Benzodiazepines

“Benzodiazepines can be dangerous when combined with alcohol. Benzodiazepines increase the effects of alcohol, making you more sleepy, dizzy or lightheaded. One danger of this is the increased risk of stumbling, falling and related injuries. Another is the increased risk of overdose. Both alcohol and benzodiazepines slow down the central nervous system, which controls breathing. In overdose, breathing can stop.” [14]

Combining Benzodiazepines with Other Medication

Taking benzodiazepines with other drugs can be unpredictable and dangerous. Always check with your doctors about combining medications.

Taking benzodiazepines with pain medicine or sleeping pills can also lead to fatal overdose.

Antihistamines—found in many over-the-counter sleep, cold, and allergy medicines—are sedating on their own. Mixing with benzodiazepines might cause over-sedation.

Be cautious when combining with antidepressants. If both are needed, you may need to adjust your dose accordingly.[15]

Birth control pills, caffeine/amphetamines/other stimulants, and Theo-Dur (theophylline) can reduce Ativan’s (a type of benzodiazepines) effects.[16]

“When taken on their own, the risk of overdose with benzodiazepines is low; however, combining these drugs with other sedatives, such as alcohol, or with medications containing codeine or other opioid drugs, can result in overdose and possible death.”[17]

Going Off of Benzodiazepines

“Giving up benzodiazepines after using them for a long time is challenging because the body has to get used to functioning without them. This is why it’s important to seek advice from a health professional when planning to stop taking benzodiazepines.”[18]

Research shows that only 35-45 percent of patients are able to withdraw from benzodiazepines without difficulty. “At least 50% of patients experience some withdrawal symptoms when they stop taking a benzodiazepine, and almost all patients experience strong withdrawal symptoms if they stop the medication suddenly.” [19]

Most experts suggest going off them quite gradually, often taking months to completely discontinue them. Ask your doctor to help you come up with a plan.

Finding an Anxiety Medication That Works for You

You and your doctor can determine what might work best for you by looking at the following:

  • Research on effectiveness
  • Side effects
  • Interactions with other medications
  • Interactions with recreational drugs
  • Pregnancy
  • Previous treatment history
  • Treatment of a family member[20]

References

[1] Smith, M., Robinson, L., & Segal, J. (2016). Is Anxiety Medication Right for You? HelpGuide.org. Retrieved from http://www.helpguide.org/articles/anxiety/anxiety-medication.htm

[2] ibid.

[3] Centre for Addiction and Mental Health. (2012). Benzodiazepines: Psychiatric Medication. Retrieved from http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/Benzodiazepines/Pages/default.aspx

[4] Edgewood Health Network Inc. (n.d.). The Facts, Effects and Dangers of Benzodiazepines. Retrieved from http://edgewoodhealthnetwork.com/blog/the-facts-effects-and-dangers-of-benzodiazepines/

[5] “Benzodiazepines (BZs)”. (n.d.). Anxieties.com. Retrieved from http://www.anxieties.com/157/benzodiazepines-bzs#.WBPiVvorLIV

[6] Healthwise Staff. (2014). Benzodiazepines for Social Anxiety Disorder. WebMD. Retrieved from http://www.webmd.com/anxiety-panic/benzodiazepines-for-social-anxiety-disorder

[7] Smith, M., Robinson, L., & Segal, J, 2016

[8] “Guidelines for Medication Use”. (n.d.). Anxieties.com. Retrieved from http://www.anxieties.com/153/med-guidelines#.WBPjvPorLIV

[9] Healthwise Staff, 2014

[10] Centre for Addiction and Mental Health, 2012

[11] Edgewood Health Network Inc., n.d.

[12] Centre for Addiction and Mental Health, 2012

[13] ibid.

[14] ibid.

[15] Smith, M., Robinson, L., & Segal, J, 2016

[16] Stanford School of Medicine. (n.d.). Psychiatric Medications – Lorazepam
Brand Name: Ativan. Stanford Medicine. Retrieved from http://whatmeds.stanford.edu/medications/lorazepam.html

[17] Centre for Addiction and Mental Health, 2012

[18] The Australian Drug Foundation. (2016). Benzodiazepine facts. Drug info. Retrieved from http://www.druginfo.adf.org.au/drug-facts/benzodiazepines

[19] “Benzodiazepines (BZs)”, n.d.

[20] Antony, M. & Norton, P. (2008). The Anti-Anxiety Workbook: Proven Strategies to Overcome Worry, Phobias, Panic, and Obsessions. New York, NY: Guilford Publications

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