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Anxiety and Stress Disorders

What is the Best Medication for Anxiety?

05/15/2009

Question:

What is the best medication to take for anxiety? The doctor has me on xanax, and I'm afraid to get addicted. Plus I hear it's only good for short term. My anxiety is long term. I`ve had it for years. Also, what's the difference between panic attacks , anxiety and stress? Thank you so much!!!

Answer:

Like is true in much of medicine, there isn't one "best" medicine for anxiety.  This is because there are multiple types of anxiety disorders, individuals are different in the way they react to medications, and individuals may have more than one illness and take other medications that must all be considered.

Panic attacks are part of an anxiety disorder called panic disorder.  The National Institutes of Mental Health define panic disorder as, "an anxiety disorder that is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress."  This website gives an excellent review of panic disorder and other types of anxiety disorders, and I recommend it to you highly to learn more about anxiety.  (http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml)

Stress is a more vague term used by different people in different way.  Essentially, stressors are forces from the outside world that affect an individual.  Stress can be physical, emotional, social and spiritual.  In many ways, how a person PERCEIVES the stress is even more important than the actual stress.  For example, a move to a new house may cause little discomfort in one person, but  someone else may feel nauseated, worry a lot, have trouble sleeping, get headaches and get angry.  The outside stress may be the same, but the internal stress reaction is very different.

Some of how we respond to stress is genetic -- we are likely born with some tendency to either "let it go" or "worry all the time."  But we can all learn better behaviors for coping with stress.

An anxiety disorder is more than just being "stressed."  An anxiety disorder is a serious disorder that can interfere with a person's ability to lead life the way he or she would like.  The most recommended medications for treating anxiety disorders ar the Selective Serotonin Reuptake Inhibitors (SSRIs) like sertraline and fluoxetine, among others.  These medications work on the chemical imbalances in the brain associated with anxiety and depression.  Studies have shown these medications to be very effective for anxiety, as is cognitive behavioral therapy.  The longest lasting effective therapy (CBT), however, is a combination of medications and CBT.  Xanax and other medications like it (valium, clonazapam) can be addicting, and most experts recommend their use for only a short while.  Some people may require long term use of these medication, but that should be in close consultation with a physician.

Good Luck.

Related Resources:

NIH NIMH anxiety

For more information:

Go to the Anxiety and Stress Disorders health topic, where you can:

Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati