According to the Epidemiology of Mental Illness Mental Health Report released by the Surgeon General in 1999, approximately 20 percent of the U.S. population is afflicted with a mental health disorder. Anxiety disorders outnumbered depressive disorders in all separate and combined data in this report. Anxiety disorders encompass generalized anxiety, panic attacks, obsessive-compulsive behaviors, anxiety linked with depression and social phobias. Despite the varied diagnoses available for anxiety problems, treatment options are consistent and are aimed at resetting brain chemicals.
Serotonin Reuptake Inhibitor Antidepressants
Selective serotonin reuptake inhibitors (SSRIs) are antidepressant drugs that are also first-line treatments for anxiety disorders. Common examples include Prozac, Celexa, Paxil and Lexapro. All of these SSRIs work similarly to stabilize brain levels of serotonin, a chemical that plays a role in a multitude of mood disorders. SSRI antidepressants are usually started at low doses that are gradually increased to treat anxiety, and benefits are usually seen gradually as well. Side effects of SSRIs are mild and include nausea and jitteriness at first use. This low side effect profile makes SSRI antidepressants preferred over other drugs for mood disorders.
Pregabalin
Lyrica, which has the generic name of pregabalin, was approved for nerve pain use in 2004 and for fibromyalgia pain use in 2007. Although Lyrica is not approved by the U.S. Food and Drug Administration (FDA) to treat anxiety disorders, studies by Drs. Feltner and Rickles, et. al., report relief of anxiety symptoms after four weeks of Lyrica at doses of 50 to 200 mg three times a day. Lyrica improves activity levels of a brain chemical called GABA, which likely causes reduced anxiety feelings. Side effects include headache, dizziness and dry mouth.
Seroquel
Seroquel, also known by its generic name, quetiapine, is an antipsychotic medicine approved in 1997 by the FDA. Since then, Seroquel has been approved to treat mental health disorders like bipolar disorder and schizophrenia. Although Seroquel is not approved to treat anxiety, an FDA review process for approval of Seroquel use in generalized anxiety began in 2008. Extended-release Seroquel 150 and 300 mg capsules have been compared with standard SSRI treatment for generalized anxiety. Benefits were observed as early as the fourth day of treatment, unlike benefits of the SSRIs. The most common side effects of Seroquel are sleepiness, dry mouth and constipation.
Benzodiazepines
Benzodiazepines are anti-anxiety, not antidepressant, drugs that were once the primary treatment options for anxiety disorders. Examples include Xanax (alprazolam) and Ativan (lorazepam), which affect the brain chemical norepinephrine. Most benzodiazepines act quickly but are not long-lasting; all are associated with high numbers of side effects, especially drowsiness, and may also lead to dependence without careful use.
About this Author
Nicole Van Hoey is a pharmacist and medical writer/editor in Washington, D.C. She has worked extensively on National Institutes of Health drug and disease publications and is a contributing textbook writer. Dr. Van Hoey currently enjoys applying her drug information expertise to writing on women’s health, complementary medicine and pediatrics.
