Generalized Anxiety Disorder (GAD) medications

If you have generalized anxiety disorder (GAD), you may receive a combination of counseling and medication to control your condition. GAD is characterized by unfounded chronic and excessive worry or worry symptoms that are more severe than normal anxiety experienced by most people. The treatment of GAD varies with prescription drugs.

Options

  • Antidepressants: Relieve symptoms of anxiety and depression
  • Benzodiazepines: usually considered as tranquilizers, which can quickly reduce anxiety
  • Azapirones: It is considered to be a mild anxiolytic drug, which takes longer to take effect than benzodiazepines. Long-term use is recommended
  • Anticonvulsants/antipsychotics: sometimes used as an option to control anxiety

Antidepressants

Interestingly, although the symptoms of anxiety and depression are different, antidepressants are usually effective in controlling anxiety. There are different classes of antidepressants that can be used to reduce GAD anxiety. More than half of people diagnosed with GAD also suffer from depression, and antidepressants can also relieve these symptoms.

Tricyclic antidepressants (TCA)

TCAs used to treat panic disorder include Tofranil (imipramine), Pamelor (nortriptyline), Norpramin (desipramine), and Anafranil (clomipramine). Unlike benzodiazepines, tricyclic drugs only need to be taken once a day.

TCA may produce a sensation similar to a panic attack. Patients with panic disorder are particularly sensitive to this effect of TCA.

At the beginning of treatment, some people may even experience symptoms, including agitation, irritability, and restlessness.

Usually, TCA treatment starts with a low dose and increases over time. Separate the doses and take most of the drugs before going to bed to alleviate some side effects. A major disadvantage of tricyclic drugs is that they can produce cardiac side effects, such as dizziness and palpitations, as well as weight gain and sedation.

Selective Serotonin Reuptake Inhibitors (SSRIs)

This category includes Lexapro (escitalopram), Paxil (paroxetine), Prozac (fluoxetine) and Zoloft (sertraline). The side effects of SSRIs are not as serious as tricyclic antidepressants (TCA). Compared with TCAs, SSRIs produce fewer cardiac effects and less weight gain and sedation.

Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)

This category includes Cymbalta (duloxetine) and Effexor (venlafaxine). They are considered as effective as SSRIs and are the first-line treatment for GAD.

Monoamine oxidase inhibitors (MAOIs)

These drugs have been found to be very effective in treating anxiety disorders, including panic disorder and social phobia. However, there are serious side effects.

People taking MAOI must follow a restrictive diet to avoid finding a substance called tyramine in certain foods. The interaction between tyramine and MAOI can trigger a hypertensive crisis characterized by a sharp increase in blood pressure.

Since antidepressants take several weeks to work, fast-acting anti-anxiety drugs, benzodiazepines, can be prescribed in the initial stages of treatment.

Benzodiazepines

When antidepressants begin to take effect, benzodiazepines can be taken regularly to control the symptoms of GAD in a short period of time. Such drugs include Klonopin (clonazepam), Ativan (lorazepam), and Xanax (alprazolam).

Among people diagnosed with GAD, the incidence of panic disorder is high. Benzodiazepines can effectively reduce panic attacks and behaviors caused by phobias (irrational fears). They are also used in the anticipated phase of a panic attack.

Benzodiazepines work quickly, and about half of people experience withdrawal symptoms after stopping the drug.

Some people may develop tolerance to them. A history of alcohol or drug abuse may be a contraindication to benzodiazepines.

Benzodiazepines can cause side effects such as sedation, and may increase the chance of falling, and cause confusion and memory problems in the elderly. If drowsiness occurs, people using heavy machinery may not be able to take benzodiazepines.

Once the prescribed antidepressants take effect, the dose of benzodiazepines can be gradually reduced until it can be safely stopped.

Azapyrones

Buspirone can also be used to treat GAD. The BuSpar brand name is no longer on the market, but generic drugs may be available. Buspirone works slowly and takes several weeks to take effect. Buspirone does not cause sedation like benzodiazepines, nor does it cause drug dependence.

Antipsychotics and anticonvulsants

Other drugs used for GAD include anticonvulsant (anti-epileptic) drugs, such as pregabalin, and antipsychotic drugs that fall into the atypical antipsychotic category, such as vortioxetine. If you do not improve with traditional therapies or experience unbearable side effects, you can consider these treatments.

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