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What is the Best Anxiety Medication?

  • By: Sleepfaster.co.uk
  • By: Dr. Dinesh John Rajkumar
What is the Best Anxiety Medication?

Is there such a thing as the 'best' anxiety medication? It's a query that millions of people in the UK and around the globe raise when anxiety takes over their lives. You're looking for a wonder drug that can deactivate worry, and even the racing heart and sleepless nights that go along with it. If you are simply consider undergoing treatment, you will very quickly understand that the answer is not just one name, but rather the whole toolkit of options.

The best anxiety medication for you is the one that gives you the most relief with the least side effects. The choice of medication is, when it comes down to it, a very personal matter, and although it is always done in very close consultation with your doctor, it also usually includes a bit of trial and error.

Let's explore the common types of medications so you can walk into your appointment well-informed.

The First Choice for Long-Term Relief: Antidepressants

When you discuss persistent anxiety with your doctor, the initial medications they commonly suggest are the drugs in the category that are scientifically called antidepressants. Do not get misled by the name! They are also used for many other mental health issues and are the first choice, or primary, of long-term anxiety therapy.

Selective Serotonin Reuptake Inhibitors (SSRIs)

The first line of treatment for anxiety in the UK is an SSRI. They are more or less available for anxiety management because most people show good tolerance towards them and they have been demonstrated as effective in a broad range of anxiety disorders, including Generalized Anxiety Disorder (GAD), panic disorder, and Social Phobia.

Mechanism of Action: The human brain communicates via chemicals called neurotransmitters; one of the most important ones that affect mood and anxiety is serotonin. When anxiety is present, there might be an imbalance of serotonin in the synapses, the space between the nerve cells. SSRIs help by preventing the nerve cells from absorbing too much serotonin too quickly. This means more serotonin is left in the space, and gradually your brain's communication system works more smoothly.

Examples:

  • Sertraline (often a first choice)
  • Citalopram
  • Escitalopram
  • Fluoxetine

Things to Note

Slow Course: SSRIs do not provide instant relief. The minimum period that they need to be taken before the effects become noticeable is 2 to 4 weeks, while 8 weeks is the maximum duration for the full effect.

Starting Jitters: It is possible that, in the first few weeks, you will experience mild anxiety, distress, or an upset stomach. It is essential to keep on taking the drug and inform your doctor about any side effects. Typically, these symptoms disappear quickly as your body gets used to the drug.

Normal Side Effects: The majority of the side effects experienced by people are mild and include nausea, dizziness, or headaches, while the more troublesome ones that last for a period can be decreased libido or difficulty in reaching orgasm. If a particular side effect is bothering you, switching to another SSRI can easily take care of it, as the different types affect the same person somewhat differently.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

If an SSRI does not work well, or your doctor believes that another option might be better for your specific symptoms, they may propose an SNRI instead.

Mechanism of Action: SNRIs enhance serotonin levels as SSRIs do but norepinephrine (also known as noradrenaline), which is responsible for alertness and concentration, is also increased. This double action can for some people be more effective in overcoming the worry and anxiety physically.

Examples:

  • Venlafaxine
  • Duloxetine

Things to Note

They possess the same delay in onset of action and side-effect profile as SSRIs, but for some, the additional impact on norepinephrine can be a life changer.

The Fast-Acting Helpers: Benzodiazepines

In case you have very intense anxiety for a short period of time or if you are in a situation that could be described as a panic attack, then a doctor might give you benzodiazepines (which is frequently abbreviated to 'benzos').

How they function

SSRIs are in no way comparable to benzodiazepines. The latter facilitate the action of GABA (gamma-aminobutyric acid), a neurotransmitter that has the effect of sound asleep, 'take it slow' in your brain. Thus the impact of GABA is reinforced and the nervous system is calmed down rapidly thus the benzos are delivering relief.

Common examples:

Things to Note

Only Short-Term: Because of their quick and powerful action, dependence may develop and also tolerance may occur. Hence they are not suitable for long-term use. They are usually prescribed for no more than 2 to 4 weeks when the patient is going through a very difficult time or while waiting for the long-term medication (like an SSRI) to take effect.

Side Effects: Drowsiness, dizziness, and a feeling of being 'foggy' or uncoordinated can be some of the side effects.

Other Important Players

Not all anxiety treatments fit neatly into the antidepressant or benzodiazepine boxes. Out of the treatments in the latter category, some people manage to get relief from anxiety by using the following alternative medications:

Buspirone (Buspar)

It is indeed an anti-anxiety medication that is primarily prescribed for Generalized Anxiety Disorder (GAD).

How The Drug Works: Its action on serotonin receptors is similar to that of selective serotonin reuptake inhibitors (SSRIs), but the mechanism of action is different. The major plus point is that unlike other similar drugs, it is not addictive and doesn't cause sedation. Therefore, it can be preferred if one wishes to minimize the risks associated with benzodiazepines.

What to Know: That being said, it takes a few weeks for the drug to build up in your body, which means it cannot provide relief from panic attacks occurring suddenly and unexpectedly.

Beta-Blockers (Propranolol)

These are in fact medications for heart conditions, but they are sometimes used in a manner that is not the main purpose of their creation-for example, off-label uses-to reduce the severity of anxiety in individuals by alleviating the physical manifestations that accompany anxiety.

How They Work: By blocking the action of adrenaline (epinephrine), the hormone that activates the 'fight or flight' response, they basically put a halt to all the physical symptoms that are usually associated with anxiety like heart palpitations, trembling, and sweating. However, they do not have any impact on the emotional aspect of anxiety (the fear).

What to Know: They are particularly suitable for performance-related anxiety like public speaking, or for situations where the physical symptoms are the major issue. The medication is sometimes taken only on 'as needed' basis just before a stressful event.

Starting Your Journey

Starting your journey to find the right anxiety medication takes courage, and it's a huge step toward feeling better. The patient should be aware that this procedure requires a lot of time and a good partnership with the doctor. It usually begins with a first conversation, during which the general practitioner will inquire thoroughly about the patient's anxiety, how exactly it disrupts their daily life, and the medications or supplements they are currently taking. Openness is a crucial factor in determining the most suitable initial point of treatment during this consultation.

Your journey won't end after that first prescription. The physician will organize a regular appointment (mostly every few weeks at the beginning) to monitor your progress. This monitoring is very important. The doctor might recommend altering the dosage or changing your medication completely if the first one is not suitable or if your symptoms have not improved sufficiently. It will take time but with the support of your healthcare professionals, you will discover the correct treatment that will restore calmness in your life.

Written by:

Dr. Dinesh John Rajkumar, Pharm D

Doctor of Pharmacy

Medical & Scientific Content Writer with 8+ Years’ Experience Specialising in Biomedical and Research Compound Literature

Disclaimer:

The content provided on this page is intended for general informational and promotional purposes only and should not be interpreted as medical, clinical, or professional advice.

Any decisions regarding diagnosis, treatment, or patient care must be made exclusively by qualified and licensed healthcare professionals based on individual circumstances.

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