Email usThere are a range of medications prescribed for the management of anxiety. Sometimes depression can be part of the whole experience and some of the newer antidepressants known as SSRI's assist in lowering anxiety levels.
Medications fall within six main groups:
(e.g. Serapax, Valium, Kalma, Xanax)
Benzodiazapines or tranquillisers were the first group of medications commonly prescribed for anxiety. They are very affective in reducing anxiety in a relatively short period (around 20 minutes). It took many years for the addictive properties of this type of drug to reach the notice of prescribing doctors and some patients developed an addiction. These days Benzodiazapines are usually only prescribed for a limited period (up to 10 days) to reduce the likelihood of addiction. They may be prescribed as a 'safety net' while the patient waits for the effects of an antidepressant to be felt.
(e.g. Betaloc, Lopresor, Minax, Corbeton)
Usually prescribed for high blood pressure and/or angina, beta-blockers can be used to treat disturbances in the heart rythm. As this medication slows the heart-rate, side effects can include: tiredness, cold hands and feet, dizziness, sleep disturbances, depression.
(e.g. Tofranil, Sinequan, Anafranil, Surmontil)
The first relatively safe and effective medication to treat depression became available over forty years ago. These were the tricyclics, named for the presence of three rings in their chemical structure. These medications are not as safe as the more recently developed SSRI's if taken in overdose. Overdose is a major concern given that depressed people are at greater risk of suicide. Like the antidepressants to follow, this group of medications take three/four weeks to take effect. Side-effects are dry mouth, blurred vision, constipation, urinary hesitation, weight gain, sedation, drowsiness, nausea, anxiety, poor concentration, low blood pressure on standing, heart palpitations and sexual dysfunction.
(e.g. Nardil, Parnate)
This group has been around as long as the Tricyclic Antidepressants. For those who cannot tolerate or have been unsuccessful with other antidepressants, MAOI's may be the best pharmacological intervention. However, there are potential dangerous interactions with a number of foods and medications. They contain a chemical called tyramine, which can raise blood pressure if it is not destroyed before it reaches the bloodstream. Many of the foods to be avoided are high in protein such as cheese, hard sausages (pepperoni, salami) or pickled herring. Also several varieties of wine and beer (but not distilled liquor) must be avoided. In addition, this drug should not be taken with pseudoephedrine (Sudafed), diet pills containing Dexatrim and most other antidepressants. Possible side-effects include lowered blood pressure, sexual dysfunction, weight gain, sedation, dry mouth and constipation.
(e.g. Prozac, Zoloft, Luvox, Aropax, Paxil)
Attempts to find medications with fewer and less serious side-effects led to the discovery of another group of medication that act more selectively. SSRI's enhance the signals in nerves that transmit messages with serotonin. Effexor - a selective serotonin and norepinepherine reuptake inhibitor, trazodone and nefazadone (Desyrel and Serzone) , - serotonin modulators, mirtazepine (Remeron), a serotonin and norepinepherine enhancer and bupropion (Wellbutrin) a norepinepherine enhancer. Side-effects include nausea, diarrhea, headache, anxiety, insomnia, tremor, sexual dysfunction and reduced motivation. Some of the SSRI's are associated with a 'discontinuation syndrome' if stopped abruptly. While not dangerous, these symptoms can quite often be confused with anxiety symptoms. In addition to their use as antidepressants, SSRI's have also been used to treat panic disorder, bulimia, obsessive compulsive disorder, excessive anger/agression and premenstral symdrome.
(e.g. St. Johns Wort, Rescue Remedy)
One of the most popular 'natural' type drugs is St. Johns Wort (Hypericum Perforatum). In Europe St. Johns Wort is commonly used to treat mild-to-moderate depression and in Germany accounts for 25% of all antidepressant type prescriptions. Research into its effectiveness for depression is vague given that the active ingredients vary from brand to brand and no account is taken for the placebo effect. While St. Johns Wort, Rescue Remedy and the like come from natural sources (flowers and vines), those who choose to take them should not forget they are drugs and should not be taken in conjunction with pharmaceutical medications without consulting a doctor. Side-effects include nausea and the reduction in metabolism of other drugs such as oral contraceptives. As with other drugs there are health risks if not taken as directed.
