Anti-anxiety drugs – types, action, natural preparations. How are anxiety disorders treated?

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Anti-anxiety drugs, or anxiolytics, are used in the pharmacotherapy of anxiety disorders, neuroses and depression. These types of drugs can complement psychotherapy, which remains one of the key methods of treating mental disorders from the group of anxiety disorders. How do anti-anxiety medications work and can they be replaced with herbal remedies?

What are anti-anxiety medications?

Anti-anxiety drugs are also called anxiolytics. This group of pharmaceuticals is characterized by a sedative, hypnotic, muscle-relaxant and anticonvulsant effect.

The first line medications for treating anxiety disorders are serotonin reuptake inhibitors (SSRIs), i.e. drugs that are normally classified as antidepressants. Their advantages include an effective anxiolytic effect and lack of addiction, but obtaining results requires a sufficiently long therapy.

The main disadvantage of SSRIs is the initial worsening of anxiety symptoms in the first phase of treatment, which then subsides. However, it is so strong that the patient may have the impression of worsening of his condition and refuse to continue taking medication or doubt the effectiveness of the therapy. Additionally, the aforementioned agents may cause side effects (agitation, insomnia, headache, constipation, diarrhea, etc.). The SSRIs include citalopram, sertraline, paroxetine.

Benzodiazepines (e.g. lorazepam and alprazolam) are these drugs with high but short-term effectiveness in reducing anxiety symptoms, their effect is observed even several minutes after taking. The use of drugs from this group is associated with the risk of addiction even with short-term use of small doses. Additionally, the patient’s tolerance to the active substance increases rapidly, so that the drug’s effect decreases significantly with the time of use, and the therapeutic effect requires increasing the dose.

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Some studies also indicate side effects of benzodiazepinessuch as effects on cognition (e.g. the presence of dementia) or worsening of the patient’s condition after stopping the medication. Benzodiazepines are also used in neurology (due to their anticonvulsant effects) and in anesthesiology.

Another anti-anxiety drug is pregabalin (a structural analog of GABA) which is effective in treating generalized anxiety disorder and social anxiety disorder. Its effects are visible already within one week of use, it can be used for short and long term, does not lead to addiction and is quite safe. Pregabalin, however, is an expensive agent that is not reimbursed in Poland.

In the treatment of anxiety disorders, hydroxyzine is also used, the effect of which, according to available studies, is similar to that of benzodiazepines. This substance alleviates the symptoms of anxiety, anxiety and psychomotor agitation occurring in neurotic disorders. It does not cause withdrawal symptoms, and somnolence is the most commonly reported side effect when taking it.

Buspirone is an anxiolytic drug, the effect of which can be noticed after 2–4 weeks of using an appropriately selected dose. It is not a potent preparation, so it is usually prescribed as part of combination therapies.

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Are anxiety disorders treated only pharmacologically?

The method of treating anxiety disorders is selected based on the type of disorder, but also on the individual condition of the patient. Pharmacotherapy may be unavoidable for severe anxiety reactions, but is often only recommended for the short term, especially with more potent drugs. Also, long-term medications are only a component of a therapeutic treatment, psychotherapy being a very important element.

Check: The course of psychotherapy – contracts, goals, methodology, duration

Although anti-anxiety medications may be helpful or even necessary, especially in the phases of exacerbation of symptoms, psychotherapy remains the basic method for stabilizing and treating anxiety disorders. The effectiveness of this method is of course influenced by the involvement of the patient and the duration of therapy. This form of help requires patience and is long-term, but it’s also safer than medications. It also gives you a better chance of achieving long-term results.

Anxiolytic drugs and types of anxiety disorders

Anti-anxiety drugs are used in the treatment of various diseases in which one of the symptoms observed in the patient is anxiety. It occurs especially in the case of anxiety disorders of a different nature. Depending on the type of disorder, the severity of symptoms and other factors occurring in specific cases, pharmacological treatment is selected by a specialist on an individual basis.

Zobacz: Anxiety neurosis – causes, symptoms, treatment

The following types of anxiety disorders can be distinguished:

1. anxiety disorders manifested as phobias (e.g., social phobias, agoraphobia, specific phobias);
2. episodic panic disorder – violent attacks of anxiety with somatic symptoms;
3. Generalized Anxiety Disorder – not as acute as panic disorder, but it is chronic and the symptoms are persistent.

When a patient develops a phobia, the forms of therapy differ, e.g. depending on the type of phobia faced by the patient. Appropriate treatment is also prescribed for other anxiety disorders. Examples of actions that could be taken include:

1. in the case of social phobia – pharmacotherapy with monoamine oxidase inhibitors (MAO) and drugs from the SSR group, and psychotherapy considered as an effective method of treating phobias as a support;
2. in the case of agoraphobia (fear of open space) – it may be advisable to take (e.g. temporarily) benzozdiazepines, but also SSRIs, but long-term psychotherapeutic treatment turns out to be of key importance in this phobia;
3. in the case of specific phobias (phobias aimed at specific situations, e.g. arachnophobia, brontophobia, ofidiophobia) – psychotherapy is used in treatment, especially behavioral psychotherapy;
4. in the case of episodic panic disorder, careful diagnosis is necessary due to the presence of symptoms such as palpitations or heart pain and dyspnoea, as well as considering the occurrence of agoraphobia; the therapy includes the support of a psychotherapist, as well as the use of benzodiazepines and SSRI drugs;
5. in the case of generalized anxiety disorders, psychotherapy is recommended first of all, and pharmacological treatment with drugs may be considered as a complementary method of therapy.

Read: Psychopathology – what does it do and help diagnose what ailments?

Natural anxiety medications – what herbs have a calming effect?

Some herbal preparations have a mild sedative and anxiolytic effect. These types of measures, however, do not last long and may be too weak to give noticeable results. Herbal preparations are also not thoroughly tested in the context of their effect on the body. For this reason, medications prescribed by doctors and psychotherapy are some and effective treatments for anxiety disorders.

In the states of mild tension or anxiety, the following herbs or their mixtures can help:

1. valerian;
2. balm;
3. hop;
4. chamomile;
5. saffron;
6. lavender;
7. St. John’s wort.