Antidepressants and Other Treatments for Anxiety Disorders

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If you are diagnosed with generalized anxiety disorder, panic disorder, or social anxiety disorder, your doctor may recommend one or some combination of the treatments described here: prescription medications, talk therapy, and relaxation and coping techniques.

Prescription Medications

Though not well understood, the causes of generalized anxiety disorder, panic disorder, and social anxiety disorder seem to involve an imbalance of certain brain chemicals, called neurotransmitters. These act as messengers between parts of the brain, or between the brain and the body. Serotonin (5HT) and norepinephrine (NE) seem to play an important role in anxiety disorders.

Nerve cells in the brain send out these neurotransmitters to deliver messages, and then take them back in (reuptake) and break them down. Antidepressants are used to try to slow down this process. This is believed to make more neurotransmitters available in the brain, which is believed to relieve symptoms.

Classes of Antidepressant Medications for Anxiety Disorders

Over the years, scientists have developed several kinds, or classes, of antidepressant medications. These medications may have different effects on different people, and many people may try more than one before they find one that works for them.

There are five main classes of antidepressants used to treat anxiety disorders:

Benzodiazepines.
These drugs were often used to treat anxiety disorders from the 1960s until the 1980s. They act on a third neurotransmitter (GABA), which seems to play a role in fear. They generally work quickly, but due to concerns about abuse or dependency, other antidepressants are now more commonly prescribed.
Tricyclic antidepressants (TCAs).
These medications were developed in the 1950s and 1960s. They help prevent reuptake of 5HT and NE, but they also affect other neurotransmitters and can have serious side effects. They are not as commonly prescribed in the United States as are newer classes of antidepressants.
Monoamine oxidase inhibitors (MAOIs).
The MAOIs were developed at about the same time as the TCAs, but they are believed to work differently. They seem to stop the brain from breaking down 5HT and NE after reuptake. People taking MAOIs should be careful about their diet and other medications to avoid problems.
Selective serotonin reuptake inhibitors (SSRIs).
The SSRIs seem to help prevent reuptake of neurotransmitters in the brain. The SSRIs are called selective because they focus on serotonin. Although the various SSRIs seem to work in basically the same way and have similar side effects, people seem to respond differently to different SSRIs.
Serotonin-norepinephrine reuptake inhibitors (SNRIs).
Developed in the 1990s, Effexor XR® (venlafaxine HCl) was the first SNRI. It works on 5HT, like an SSRI, but also helps prevent reuptake of NE. Effexor XR is approved to treat generalized anxiety disorder, and it is also approved for panic disorder, social anxiety disorder, and major depressive disorder.

Learn more about Effexor XR.

Talk Therapy for Anxiety Disorders

Many people with anxiety disorders also benefit from talk therapy (psychotherapy). Talk therapy helps you work toward changing the way you view the world around you and how you react to it. Talking with a psychiatrist or another qualified health care professional can help you explore your relationships, feelings, and experiences in a meaningful way, to help you interact with others again.

There are three main types of talk therapy:

  • Cognitive-behavioral therapy (CBT) — helps a person recognize negative thought patterns and behaviors and replace them with positive ones. CBT can quickly bring important changes to a person's daily life and outlook for the future.
  • Interpersonal therapy (IPT) — focuses on working through troubled personal and social relationships that may contribute to a person's condition. By learning how to deal with others more effectively, a person may be able to reduce conflict in daily life and gain support from family and friends.
  • Psychodynamic therapy — helps a person look within himself or herself to uncover and understand emotional conflicts that may be contributing to his or her condition.