Medications: Anti-Anxiety Medications
Updated 5/10/09
Many people with bipolar disorder experience high levels of anxiety. This is much more severe than the kind of nervousness one occasionally experiences before going to a job interview. Patients who suffer from bipolar disorder or an anxiety disorder may experience extreme anxiety for prolonged periods of time, often with panic attacks. Symptoms include the feeling of butterflies in one’s stomach, sweaty palms, irritability, jumpiness, uneasiness, apprehensiveness, changes in heartbeat, nausea, stomachaches, dizziness, and shortness of breath.
A high level of anxiety for a prolonged period of time can impair daily functioning. Often, medication is needed. Professionals treat anxiety with antidepressants and antianxiety medications. I will discuss antidepressants in my next article.
Benzodiazepines are commonly used to treat anxiety, but they are like band-aids: treating the symptoms, but not the cause. These medicines temporarily relieve anxiety symptoms. For someone who has severe anxiety, the anxiety returns when the drug wears off. Benzodiazepines include alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin), and diazepam (Valium).
Side effects of benzodiazepines include drowsiness, loss of coordination, fatigue, and confusion. That’s why it’s not a good idea to drive or operate machinery while on this type of medication. Benzodiazepines may be taken 1 to 3 times per day, or only as needed. Usually, the doctor prescribes a low dosage at first and gradually raises it until the symptoms are gone. Dosage varies depending on the person and the symptoms.
Alcohol should be avoided while taking these medications. Alcohol consumption can cause life-threatening complications for people who are on benzodiazepines. You should also tell your doctor about any other medications you take. Dependence can occur with prolonged use, so physicians often prescribe these drugs for brief periods of time or “as needed” for anxiety attacks. For patients who need long-term treatment, perhaps other types of medications should be considered. Withdrawal symptoms may occur when discontinuing the medication, so talk with your doctor before you stop taking it. The doctor will usually “wean” someone off the benzodiazepine if he or she has been on it for a long time, gradually reducing the dose before stopping it completely.
Buspirone (BuSpar) is another type of anti-anxiety med that is not a benzodiazepine. BuSpar must be taken regularly for a minimum of two weeks to see results and can’t be taken “as needed.”
Beta-blockers such as Propranolol are sometimes prescribed to relieve performance anxiety. Beta blockers are for treating heart conditions and lowering blood pressure, and therefore are not a common anti-anxiety medication.
I have tried all the benzodiazepines listed above, but I am currently on Ativan. I take it at night to help me sleep. I was taking Klonopin at night but it was too long-lasting and left me feeling tired the next day. Ativan lasts only four to six hours, and while it doesn’t help me sleep all night, it helps for at least half of the night. I don’t experience much anxiety anymore, and when I do, I just take .5 mg of Ativan when I experience it and I calm down within an hour.
