![Medications used to treat anxiety include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), benzodiazepines, and others.](https://images.medicinenet.com/images/article/main_image/how-do-you-treat-anxiety-in-the-elderly.jpg?output-quality=75)
Anxiety disorders are a common type of psychiatric disorder characterized by anxiety or fear that does not diminish over time.
Types of anxiety disorders include:
- Generalized anxiety disorder
- Social anxiety disorder (social phobia)
- Panic disorder
- Separation anxiety disorder
- Phobias
- Selective mutism
- Substance/medication-induced anxiety disorder
- Anxiety disorders due to other medical conditions
Medications Used for Anxiety
Treatment for anxiety disorders usually consists of a combination of medication and/or psychotherapy.
The main types of medications used to treat anxiety disorders include:
- Antidepressants
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor and Effexor XR)
- Atypical antidepressants
- Mirtazapine (Remeron)
- Nefazodone (Serzone)
- Trazodone (Desyrel)
- Tricyclic antidepressants
- Monoamine oxidase inhibitors (MAOIs)
- Benzodiazepines, especially in emergency situations
- Anti-anxiety drugs
- Anticonvulsants
- Divalproex (Depakote)
- Gabapentin (Neurontin)
- Pregabalin (Lyrica)
- Antihypertensive drugs
- Atenolol (Tenormin)
- Clonidine (Catapres)
- Nadolol (Corgard)
- Propranolol (Inderal, Betachron E-R, InnoPran XL)
Types of therapy used to treat anxiety disorders include:
- Behavioral therapy and cognitive behavioral therapy (CBT)
- Computerized CBT (FearFighter)
- Psychodynamic therapy (or insight-oriented therapy) is rarely used on its own for phobias but may be used for phobic disorders that overlap personality disorders
- Supportive psychotherapy
- Interpersonal psychotherapy
- Relaxation therapy
- Mindfulness therapy
Other treatments used for anxiety disorders include:
- Cranial electrotherapy stimulator (CES)
Hospitalization may be needed to treat anxiety disorders in severe cases such as:
- Severe functional impairment (cannot meet own daily needs)
- Deficits in social skills
- Suicide or homicide risk
- If you or someone you know are in crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.
What Are Symptoms of Anxiety Disorders?
Symptoms of anxiety disorders vary depending on the type of anxiety disorder present and may include:
- Excessive anxiety and worry that is difficult to control
- Restlessness or feeling on edge
- Being easily fatigued
- Irritability
- Difficulty concentrating
- Sleep problems
- Muscle tension
- Fears that may hinder functioning at work or school
- Of social situations
- Of judgment by others
- Of humiliation or embarrassment
- Of being trapped with no escape
- To specific situations (such as flying, heights, animals, insects, blood, needles)
- Chest pain
- Shortness of breath
- Feeling as if a heart attack is occurring (patients may come to a hospital’s emergency department because they fear a heart attack is happening)
- Changes in personality, such as a person becoming more passive, dependent, or withdrawn
- Intense anxiety when exposed to specific situations such as heights, small spaces, animals, or storms
- Panic attacks, which are sudden periods of intense fear or discomfort accompanied by 4 or more of the following 13 symptoms:
- Palpitations or fast heart rate
- Sweating
- Trembling or shaking
- Shortness of breath or feeling of being smothered
- Feeling of choking
- Chest pain or discomfort
- Nausea or abdominal upset
- Dizziness, unsteadiness, lightheadedness, or fainting
- Feeling hot or cold
- Numbness or tingling sensations
- Disconnect from surroundings or self (derealization or depersonalization)
- Fear of losing control or going crazy
- Fear of death
- Sense of impending doom
- Urge to flee or escape
- Headache
- Cold hands
- Diarrhea
- Insomnia
- Fatigue
- Intrusive thoughts
- Repetitive thoughts (ruminations)
How Are Anxiety Disorders Diagnosed?
Anxiety disorders are usually diagnosed with a psychological evaluation. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association provides diagnostic criteria for an anxiety disorder.
Lab studies to diagnose or exclude medical conditions that may cause anxiety disorders include:
- Complete blood cell (CBC) count
- Chemistry profile
- Thyroid function tests
- Urinalysis
- Urine drug screen
Tests to rule out other disorders that can cause anxiety or symptoms that resemble anxiety may include:
- Electroencephalography (EEG)
- Lumbar puncture
- Brain computed tomography (CT) scan
- Magnetic resonance imaging (MRI) of the brain
- Neurologic consultation
- Positron emission tomography (PET) scan
- Electrocardiography (ECG)
- Treadmill ECG
- Rapid plasma reagent test
- Lumbar puncture (CNS infections)
- HIV testing
- Arterial blood gas analysis
- Chest X-ray
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